| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
67,573 |
66,212 |
$6.42M |
| E0601 |
Cont airway pressure device |
22,504 |
22,358 |
$1.32M |
| A7030 |
Cpap full face mask |
10,823 |
10,723 |
$1.13M |
| E0570 |
Nebulizer with compression |
41,503 |
41,272 |
$848K |
| E0431 |
Portable gaseous 02 |
44,689 |
43,094 |
$763K |
| E0603 |
Electric breast pump |
5,379 |
5,360 |
$727K |
| T4541 |
Large disposable underpad |
5,324 |
5,156 |
$655K |
| B4035 |
Enteral feed supp pump per d |
3,493 |
3,001 |
$631K |
| A7031 |
Replacement facemask interfa |
11,510 |
11,388 |
$622K |
| T4527 |
Adult size pull-on lg |
4,097 |
4,042 |
$584K |
| E0470 |
Rad w/o backup non-inv intfc |
4,662 |
4,622 |
$582K |
| B4161 |
Ef ped hydrolyzed/amino acid |
431 |
389 |
$537K |
| T4523 |
Adult size brief/diaper lg |
3,297 |
3,179 |
$482K |
| T4522 |
Adult size brief/diaper med |
4,296 |
4,200 |
$470K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,553 |
1,425 |
$462K |
| T4526 |
Adult size pull-on med |
3,269 |
3,235 |
$415K |
| A4604 |
Tubing with heating element |
10,223 |
10,138 |
$411K |
| E0562 |
Humidifier heated used w pap |
6,449 |
6,403 |
$388K |
| E0202 |
Phototherapy light w/ photom |
6,771 |
1,388 |
$371K |
| A7034 |
Nasal application device |
5,596 |
5,532 |
$353K |
| T4524 |
Adult size brief/diaper xl |
2,293 |
2,218 |
$347K |
| K0001 |
Standard wheelchair |
14,134 |
13,855 |
$323K |
| T4528 |
Adult size pull-on xl |
1,870 |
1,845 |
$296K |
| A7032 |
Replacement nasal cushion |
4,835 |
4,752 |
$288K |
| A4351 |
Straight tip urine catheter |
1,200 |
1,145 |
$276K |
| T4534 |
Youth size pull-on |
1,991 |
1,957 |
$265K |
| A7038 |
Pos airway pressure filter |
27,038 |
26,659 |
$219K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,865 |
4,746 |
$217K |
| A7035 |
Pos airway press headgear |
10,326 |
10,161 |
$207K |
| B4150 |
Ef complet w/intact nutrient |
1,770 |
1,567 |
$204K |
| E0118 |
Crutch substitute |
2,296 |
2,256 |
$197K |
| E0445 |
Oximeter non-invasive |
1,214 |
1,181 |
$186K |
| E0143 |
Walker folding wheeled w/o s |
3,744 |
3,680 |
$173K |
| E0424 |
Stationary compressed gas 02 |
1,475 |
1,470 |
$167K |
| K0003 |
Lightweight wheelchair |
3,994 |
3,947 |
$159K |
| T4530 |
Ped size brief/diaper lg |
1,304 |
1,288 |
$134K |
| E1392 |
Portable oxygen concentrator |
4,245 |
4,207 |
$133K |
| B9998 |
Enteral supp not otherwise c |
1,194 |
1,108 |
$109K |
| A7037 |
Pos airway pressure tubing |
5,655 |
5,603 |
$109K |
| E0471 |
Rad w/backup non inv intrfc |
407 |
388 |
$98K |
| T4543 |
Adult disp brief/diap abv xl |
448 |
441 |
$91K |
| E1399 |
Durable medical equipment mi |
672 |
613 |
$90K |
| A7046 |
Repl water chamber, pap dev |
6,964 |
6,908 |
$84K |
| T4525 |
Adult size pull-on sm |
519 |
508 |
$77K |
| A7033 |
Replacement nasal pillows |
1,651 |
1,627 |
$74K |
| A9901 |
Delivery/set up/dispensing |
12,806 |
11,736 |
$68K |
| B9002 |
Enter nutr inf pump any type |
833 |
817 |
$64K |
| T4521 |
Adult size brief/diaper sm |
604 |
587 |
$63K |
| A4927 |
Non-sterile gloves |
6,346 |
6,133 |
$61K |
| T4529 |
Ped size brief/diaper sm/med |
479 |
463 |
$50K |
| E0630 |
Patient lift hydraulic |
1,193 |
1,169 |
$49K |
| A4520 |
Incontinence garment anytype |
667 |
649 |
$47K |
| B4152 |
Ef calorie dense>/=1.5kcal |
326 |
285 |
$40K |
| A4409 |
Ost skn barr convex <=4 sq i |
390 |
380 |
$37K |
| A4385 |
Ost skn barrier sld ext wear |
529 |
507 |
$37K |
| A4670 |
Automatic bp monitor, dial |
812 |
808 |
$37K |
| E0240 |
Bath/shower chair |
771 |
769 |
$36K |
| T4533 |
Youth size brief/diaper |
267 |
255 |
$34K |
| T4535 |
Disposable liner/shield/pad |
538 |
529 |
$33K |
| E0700 |
Safety equipment |
389 |
385 |
$30K |
| A6402 |
Sterile gauze <= 16 sq in |
2,798 |
2,563 |
$30K |
| A4452 |
Waterproof tape |
1,336 |
1,266 |
$29K |
| B4088 |
Gastro/jejuno tube, low-pro |
297 |
288 |
$28K |
| E0600 |
Suction pump portab hom modl |
959 |
947 |
$28K |
| E0163 |
Commode chair with fixed arm |
481 |
476 |
$26K |
| K0195 |
Elevating whlchair leg rests |
2,338 |
2,313 |
$24K |
| A7000 |
Disposable canister for pump |
1,293 |
1,235 |
$21K |
| E0730 |
Tens four lead |
83 |
83 |
$19K |
| B4087 |
Gastro/jejuno tube, std |
388 |
377 |
$16K |
| A4624 |
Tracheal suction tube |
247 |
198 |
$16K |
| A4357 |
Bedside drainage bag |
1,100 |
1,059 |
$14K |
| B4149 |
Ef blenderized foods |
40 |
38 |
$13K |
| A7039 |
Filter, non disposable w pap |
1,908 |
1,892 |
$13K |
| E0156 |
Walker seat attachment |
1,014 |
1,002 |
$11K |
| A4322 |
Irrigation syringe |
600 |
573 |
$10K |
| A4425 |
Ost pch drain for barrier fl |
144 |
140 |
$9K |
| A7526 |
Tracheostomy tube collar |
181 |
169 |
$9K |
| A9900 |
Supply/accessory/service |
129 |
115 |
$8K |
| A4595 |
Tens suppl 2 lead per month |
244 |
230 |
$7K |
| A7004 |
Disposable nebulizer sml vol |
5,560 |
5,470 |
$7K |
| A5120 |
Skin barrier, wipe or swab |
893 |
833 |
$7K |
| A7520 |
Trach/laryn tube non-cuffed |
120 |
114 |
$6K |
| A4335 |
Incontinence supply |
457 |
445 |
$6K |
| A7003 |
Nebulizer administration set |
2,849 |
2,819 |
$6K |
| A7015 |
Aerosol mask used w nebulize |
3,916 |
3,858 |
$6K |
| A6242 |
Hydrogel drg <=16 in w/o bdr |
40 |
38 |
$6K |
| A4554 |
Disposable underpads |
150 |
146 |
$5K |
| B4034 |
Enter feed supkit syr by day |
51 |
50 |
$4K |
| E0114 |
Crutch underarm pair no wood |
138 |
138 |
$4K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
16 |
14 |
$4K |
| A4627 |
Spacer bag/reservoir |
252 |
250 |
$3K |
| T4544 |
Adlt disp und/pull on abv xl |
12 |
12 |
$3K |
| A4456 |
Adhesive remover, wipes |
291 |
279 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
38 |
38 |
$3K |
| E0776 |
Iv pole |
243 |
242 |
$3K |
| A5063 |
Drain ostomy pouch w/flange |
53 |
53 |
$3K |
| E0245 |
Tub stool or bench |
65 |
65 |
$2K |
| K0006 |
Heavy duty wheelchair |
27 |
26 |
$2K |
| E0159 |
Brake for wheeled walker |
258 |
255 |
$2K |
| E0990 |
Wheelchair elevating leg res |
217 |
215 |
$1K |
| A4217 |
Sterile water/saline, 500 ml |
51 |
49 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
159 |
152 |
$1K |
| E0434 |
Portable liquid 02 |
60 |
60 |
$1K |
| A4628 |
Oropharyngeal suction cath |
117 |
115 |
$949.96 |
| A4450 |
Non-waterproof tape |
241 |
232 |
$709.44 |
| E2601 |
Gen w/c cushion wdth < 22 in |
27 |
26 |
$708.04 |
| A4629 |
Tracheostomy care kit |
12 |
12 |
$684.30 |
| E0149 |
Heavy duty wheeled walker |
12 |
12 |
$618.37 |
| A6445 |
Conform band s w <3"/yd |
25 |
25 |
$613.92 |
| A4216 |
Sterile water/saline, 10 ml |
76 |
74 |
$543.47 |
| E0185 |
Gel pressure mattress pad |
13 |
13 |
$425.63 |
| A6248 |
Hydrogel drsg gel filler |
26 |
25 |
$417.10 |
| A4213 |
20+ cc syringe only |
82 |
79 |
$403.15 |
| A4338 |
Indwelling catheter latex |
45 |
40 |
$347.47 |
| A4406 |
Pectin based ostomy paste |
25 |
25 |
$300.23 |
| A7036 |
Pos airway press chinstrap |
26 |
26 |
$266.02 |
| A6216 |
Non-sterile gauze<=16 sq in |
30 |
25 |
$181.00 |
| E0910 |
Trapeze bar attached to bed |
14 |
14 |
$120.29 |
| A7002 |
Tubing used w suction pump |
12 |
12 |
$66.94 |