| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
28,952 |
28,535 |
$2.39M |
| E0465 |
Home vent invasive interface |
2,808 |
2,577 |
$1.41M |
| E0445 |
Oximeter non-invasive |
3,777 |
3,709 |
$440K |
| E0601 |
Cont airway pressure device |
8,336 |
8,282 |
$423K |
| A4624 |
Tracheal suction tube |
2,779 |
2,672 |
$397K |
| E0431 |
Portable gaseous 02 |
17,290 |
17,066 |
$308K |
| A7030 |
Cpap full face mask |
4,367 |
4,357 |
$251K |
| E0570 |
Nebulizer with compression |
8,158 |
8,080 |
$221K |
| E0470 |
Rad w/o backup non-inv intfc |
2,028 |
2,007 |
$209K |
| A4629 |
Tracheostomy care kit |
1,468 |
1,423 |
$176K |
| E1392 |
Portable oxygen concentrator |
3,272 |
3,227 |
$158K |
| E0562 |
Humidifier heated used w pap |
2,138 |
2,130 |
$152K |
| E0143 |
Walker folding wheeled w/o s |
2,918 |
2,903 |
$140K |
| A7031 |
Replacement facemask interfa |
4,918 |
4,843 |
$140K |
| K0001 |
Standard wheelchair |
6,411 |
6,266 |
$140K |
| B4035 |
Enteral feed supp pump per d |
931 |
892 |
$127K |
| E0630 |
Patient lift hydraulic |
1,612 |
1,570 |
$82K |
| A4554 |
Disposable underpads |
1,007 |
992 |
$76K |
| A7034 |
Nasal application device |
3,068 |
3,062 |
$75K |
| E0466 |
Home vent non-invasive inter |
215 |
213 |
$70K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,093 |
1,073 |
$69K |
| A7000 |
Disposable canister for pump |
4,991 |
4,822 |
$66K |
| A7520 |
Trach/laryn tube non-cuffed |
1,676 |
1,565 |
$66K |
| A7035 |
Pos airway press headgear |
5,674 |
5,664 |
$66K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,295 |
2,242 |
$63K |
| T4522 |
Adult size brief/diaper med |
573 |
568 |
$56K |
| A7032 |
Replacement nasal cushion |
2,755 |
2,651 |
$55K |
| E0482 |
Cough stimulating device |
316 |
310 |
$52K |
| A7037 |
Pos airway pressure tubing |
6,226 |
6,204 |
$48K |
| E0600 |
Suction pump portab hom modl |
1,063 |
1,034 |
$47K |
| E0163 |
Commode chair with fixed arm |
739 |
735 |
$42K |
| A4605 |
Trach suction cath close sys |
1,260 |
1,178 |
$42K |
| A4217 |
Sterile water/saline, 500 ml |
2,920 |
2,753 |
$40K |
| E1399 |
Durable medical equipment mi |
499 |
399 |
$36K |
| A7002 |
Tubing used w suction pump |
4,647 |
4,465 |
$36K |
| E0990 |
Wheelchair elevating leg res |
2,651 |
2,537 |
$36K |
| E0240 |
Bath/shower chair |
617 |
614 |
$34K |
| A7526 |
Tracheostomy tube collar |
1,133 |
1,093 |
$28K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
221 |
217 |
$28K |
| T4521 |
Adult size brief/diaper sm |
297 |
295 |
$28K |
| A4628 |
Oropharyngeal suction cath |
4,130 |
3,934 |
$26K |
| A7521 |
Trach/laryn tube cuffed |
654 |
614 |
$24K |
| E0247 |
Trans bench w/wo comm open |
329 |
329 |
$22K |
| A7038 |
Pos airway pressure filter |
8,836 |
8,742 |
$22K |
| A7005 |
Nondisposable nebulizer set |
1,450 |
1,447 |
$19K |
| T4523 |
Adult size brief/diaper lg |
143 |
143 |
$17K |
| A6402 |
Sterile gauze <= 16 sq in |
2,094 |
1,973 |
$16K |
| A6530 |
Compression stocking bk18-30 |
546 |
400 |
$14K |
| A4481 |
Tracheostoma filter |
255 |
251 |
$12K |
| A4623 |
Tracheostomy inner cannula |
438 |
423 |
$11K |
| E1226 |
Manual fully reclining back |
225 |
218 |
$11K |
| A9900 |
Supply/accessory/service |
39 |
39 |
$11K |
| A7033 |
Replacement nasal pillows |
719 |
706 |
$10K |
| E0565 |
Compressor air power source |
313 |
303 |
$10K |
| A4927 |
Non-sterile gloves |
2,452 |
2,408 |
$9K |
| K0195 |
Elevating whlchair leg rests |
1,656 |
1,627 |
$9K |
| E0156 |
Walker seat attachment |
809 |
807 |
$9K |
| S8101 |
Spacer with mask |
300 |
299 |
$9K |
| A7003 |
Nebulizer administration set |
2,757 |
2,717 |
$8K |
| A4606 |
Oxygen probe used w oximeter |
245 |
224 |
$8K |
| A7007 |
Lg vol nebulizer disposable |
1,017 |
983 |
$7K |
| A7046 |
Repl water chamber, pap dev |
1,877 |
1,865 |
$6K |
| A4604 |
Tubing with heating element |
929 |
925 |
$5K |
| A7039 |
Filter, non disposable w pap |
2,616 |
2,601 |
$5K |
| A7525 |
Tracheostomy mask |
1,602 |
1,547 |
$5K |
| E0149 |
Heavy duty wheeled walker |
154 |
154 |
$5K |
| T4524 |
Adult size brief/diaper xl |
28 |
28 |
$3K |
| A6453 |
Self-adher band w <3"/yd |
1,084 |
1,075 |
$2K |
| A4402 |
Lubricant per ounce |
697 |
685 |
$2K |
| E0181 |
Press pad alternating w/ pum |
139 |
139 |
$2K |
| K0003 |
Lightweight wheelchair |
38 |
38 |
$2K |
| A4244 |
Alcohol or peroxide per pint |
767 |
739 |
$2K |
| K0007 |
Extra heavy duty wheelchair |
41 |
40 |
$2K |
| B4150 |
Ef complet w/intact nutrient |
12 |
12 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
42 |
42 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,562 |
1,545 |
$1K |
| T4535 |
Disposable liner/shield/pad |
29 |
29 |
$1K |
| T4537 |
Reusable underpad bed size |
24 |
24 |
$822.52 |
| A6454 |
Self-adher band w>=3" <5"/yd |
398 |
379 |
$688.66 |
| E0100 |
Cane adjust/fixed with tip |
71 |
71 |
$683.97 |
| L3908 |
Who cock-up nonmolde pre ots |
17 |
13 |
$497.33 |
| A4357 |
Bedside drainage bag |
25 |
25 |
$278.35 |
| A7507 |
Integrated filter & holder |
13 |
12 |
$199.00 |
| A7010 |
Disposable corrugated tubing |
16 |
16 |
$73.70 |
| A4245 |
Alcohol wipes per box |
13 |
13 |
$20.08 |
| A4450 |
Non-waterproof tape |
12 |
12 |
$19.89 |