| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
71,464 |
70,702 |
$4.03M |
| E0601 |
Cont airway pressure device |
63,123 |
62,674 |
$1.78M |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,676 |
1,450 |
$1.40M |
| E2402 |
Neg press wound therapy pump |
1,989 |
1,897 |
$1.25M |
| K0001 |
Standard wheelchair |
48,371 |
47,812 |
$1.09M |
| E0470 |
Rad w/o backup non-inv intfc |
10,281 |
10,215 |
$744K |
| E0431 |
Portable gaseous 02 |
67,013 |
65,428 |
$693K |
| E0562 |
Humidifier heated used w pap |
74,861 |
74,349 |
$674K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,925 |
3,779 |
$589K |
| E0471 |
Rad w/backup non inv intrfc |
2,958 |
2,936 |
$587K |
| A9276 |
Disposable sensor, cgm sys |
824 |
800 |
$572K |
| E0277 |
Powered pres-redu air mattrs |
3,151 |
3,042 |
$532K |
| E0144 |
Enclosed walker w rear seat |
4,437 |
4,385 |
$483K |
| E0570 |
Nebulizer with compression |
11,769 |
11,679 |
$480K |
| E0465 |
Home vent invasive interface |
1,292 |
1,113 |
$435K |
| T4541 |
Large disposable underpad |
30,031 |
29,045 |
$435K |
| A4353 |
Intermittent urinary cath |
2,034 |
1,783 |
$432K |
| E0143 |
Walker folding wheeled w/o s |
12,970 |
12,873 |
$431K |
| E0295 |
Hosp bed semi-elect w/o matt |
10,614 |
10,506 |
$403K |
| K0003 |
Lightweight wheelchair |
10,721 |
10,670 |
$342K |
| A4351 |
Straight tip urine catheter |
4,303 |
3,922 |
$316K |
| A7034 |
Nasal application device |
8,527 |
8,454 |
$314K |
| A9274 |
Ext amb insulin delivery sys |
330 |
325 |
$312K |
| A6197 |
Alginate drsg >16 <=48 sq in |
1,479 |
1,408 |
$309K |
| A4224 |
Supply insulin inf cath/wk |
461 |
440 |
$306K |
| A4230 |
Infus insulin pump non needl |
1,920 |
1,866 |
$294K |
| B4150 |
Ef complet w/intact nutrient |
1,965 |
1,647 |
$292K |
| T4526 |
Adult size pull-on med |
9,789 |
9,369 |
$283K |
| A4385 |
Ost skn barrier sld ext wear |
3,739 |
3,568 |
$281K |
| T4523 |
Adult size brief/diaper lg |
9,163 |
8,919 |
$277K |
| B4035 |
Enteral feed supp pump per d |
2,228 |
2,007 |
$257K |
| E0784 |
Ext amb infusn pump insulin |
1,172 |
1,171 |
$249K |
| A4409 |
Ost skn barr convex <=4 sq i |
2,825 |
2,616 |
$240K |
| A7030 |
Cpap full face mask |
6,623 |
6,542 |
$239K |
| E0483 |
Hi freq chest wall oscil sys |
510 |
509 |
$234K |
| T4527 |
Adult size pull-on lg |
8,135 |
7,839 |
$232K |
| K0006 |
Heavy duty wheelchair |
4,362 |
4,316 |
$221K |
| T4535 |
Disposable liner/shield/pad |
14,154 |
13,277 |
$218K |
| E0303 |
Hosp bed hvy dty xtra wide |
1,995 |
1,962 |
$217K |
| A7035 |
Pos airway press headgear |
15,227 |
15,022 |
$179K |
| B4152 |
Ef calorie dense>/=1.5kcal |
958 |
805 |
$177K |
| T4522 |
Adult size brief/diaper med |
7,310 |
7,127 |
$176K |
| B9998 |
Enteral supp not otherwise c |
2,940 |
2,496 |
$169K |
| T4528 |
Adult size pull-on xl |
5,429 |
5,200 |
$166K |
| E0163 |
Commode chair with fixed arm |
4,352 |
4,320 |
$150K |
| A6550 |
Neg pres wound ther drsg set |
2,964 |
1,520 |
$142K |
| T4524 |
Adult size brief/diaper xl |
4,917 |
4,707 |
$140K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,170 |
1,157 |
$127K |
| A7037 |
Pos airway pressure tubing |
11,728 |
11,608 |
$126K |
| E0603 |
Electric breast pump |
4,929 |
4,920 |
$120K |
| A4425 |
Ost pch drain for barrier fl |
2,686 |
2,474 |
$114K |
| B9002 |
Enter nutr inf pump any type |
1,372 |
1,357 |
$112K |
| A4225 |
Sup/ext insulin inf pump syr |
390 |
382 |
$105K |
| A4407 |
Ext wear ost skn barr <=4sq" |
905 |
875 |
$104K |
| E0305 |
Rails bed side half length |
10,831 |
10,696 |
$103K |
| A9277 |
External transmitter, cgm |
181 |
180 |
$103K |
| T4534 |
Youth size pull-on |
2,234 |
2,164 |
$99K |
| B4034 |
Enter feed supkit syr by day |
3,113 |
2,946 |
$97K |
| A5500 |
Diab shoe for density insert |
2,035 |
2,029 |
$94K |
| T4525 |
Adult size pull-on sm |
4,388 |
4,184 |
$88K |
| A4604 |
Tubing with heating element |
3,945 |
3,896 |
$87K |
| E0630 |
Patient lift hydraulic |
2,957 |
2,928 |
$85K |
| A7000 |
Disposable canister for pump |
6,060 |
4,330 |
$80K |
| A4670 |
Automatic bp monitor, dial |
3,619 |
3,588 |
$77K |
| E0240 |
Bath/shower chair |
3,086 |
3,052 |
$76K |
| E0600 |
Suction pump portab hom modl |
3,227 |
3,165 |
$72K |
| A7038 |
Pos airway pressure filter |
9,474 |
9,384 |
$70K |
| L3000 |
Ft insert ucb berkeley shell |
1,140 |
1,140 |
$69K |
| K0195 |
Elevating whlchair leg rests |
7,328 |
7,244 |
$69K |
| A4232 |
Syringe w/needle insulin 3cc |
2,021 |
1,983 |
$65K |
| E0271 |
Mattress innerspring |
9,341 |
9,216 |
$64K |
| A6402 |
Sterile gauze <= 16 sq in |
6,183 |
5,680 |
$59K |
| A4628 |
Oropharyngeal suction cath |
1,711 |
1,582 |
$57K |
| T4533 |
Youth size brief/diaper |
2,264 |
2,140 |
$57K |
| K0108 |
W/c component-accessory nos |
328 |
106 |
$54K |
| T4531 |
Ped size pull-on sm/med |
613 |
588 |
$50K |
| E0990 |
Wheelchair elevating leg res |
2,618 |
2,591 |
$43K |
| A7033 |
Replacement nasal pillows |
2,498 |
2,450 |
$42K |
| E1392 |
Portable oxygen concentrator |
4,304 |
4,263 |
$42K |
| A7031 |
Replacement facemask interfa |
2,063 |
2,046 |
$40K |
| A4623 |
Tracheostomy inner cannula |
678 |
629 |
$38K |
| L1820 |
Ko elas w/ condyle pads & jo |
1,079 |
1,063 |
$38K |
| A7520 |
Trach/laryn tube non-cuffed |
937 |
865 |
$37K |
| A4217 |
Sterile water/saline, 500 ml |
6,235 |
5,854 |
$35K |
| A6212 |
Foam drg <=16 sq in w/border |
482 |
446 |
$35K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
1,620 |
1,564 |
$34K |
| A7032 |
Replacement nasal cushion |
1,898 |
1,866 |
$32K |
| A4357 |
Bedside drainage bag |
3,316 |
3,118 |
$31K |
| A5061 |
Pouch drainable w barrier at |
361 |
343 |
$30K |
| A4649 |
Surgical supplies |
2,309 |
1,904 |
$30K |
| A6446 |
Conform band s w>=3" <5"/yd |
3,016 |
2,879 |
$30K |
| A6216 |
Non-sterile gauze<=16 sq in |
5,491 |
5,313 |
$30K |
| L4360 |
Pneumat walking boot pre cst |
328 |
324 |
$29K |
| A5513 |
Multi den insert custom mold |
894 |
893 |
$29K |
| A5120 |
Skin barrier, wipe or swab |
5,568 |
5,324 |
$28K |
| L4361 |
Pneuma/vac walk boot pre ots |
674 |
671 |
$28K |
| A4452 |
Waterproof tape |
2,391 |
2,298 |
$27K |
| A4358 |
Urinary leg or abdomen bag |
2,321 |
2,194 |
$27K |
| E1031 |
Rollabout chair with casters |
1,534 |
1,526 |
$26K |
| A4456 |
Adhesive remover, wipes |
4,874 |
4,621 |
$26K |
| A4927 |
Non-sterile gloves |
7,212 |
6,799 |
$24K |
| A4338 |
Indwelling catheter latex |
905 |
833 |
$24K |
| A5063 |
Drain ostomy pouch w/flange |
652 |
630 |
$24K |
| A7526 |
Tracheostomy tube collar |
1,527 |
1,437 |
$23K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
657 |
627 |
$23K |
| A4349 |
Disposable male external cat |
1,254 |
1,053 |
$23K |
| A7046 |
Repl water chamber, pap dev |
3,510 |
3,489 |
$22K |
| A4624 |
Tracheal suction tube |
1,524 |
1,333 |
$21K |
| E0114 |
Crutch underarm pair no wood |
1,401 |
1,382 |
$21K |
| A4406 |
Pectin based ostomy paste |
2,145 |
2,066 |
$20K |
| L3908 |
Who cock-up nonmolde pre ots |
1,369 |
1,246 |
$20K |
| A4335 |
Incontinence supply |
3,789 |
3,530 |
$19K |
| A4394 |
Ostomy pouch liq deodorant |
1,700 |
1,627 |
$19K |
| A5512 |
Multi den insert direct form |
528 |
527 |
$18K |
| A4388 |
Drainable pch w ex wear barr |
221 |
209 |
$17K |
| A4310 |
Insert tray w/o bag/cath |
1,379 |
1,297 |
$14K |
| A4629 |
Tracheostomy care kit |
988 |
942 |
$14K |
| T4521 |
Adult size brief/diaper sm |
724 |
701 |
$14K |
| A4362 |
Solid skin barrier |
322 |
309 |
$14K |
| A6250 |
Skin seal protect moisturizr |
3,269 |
3,183 |
$13K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,954 |
1,947 |
$13K |
| E0443 |
Portable 02 contents, gas |
402 |
304 |
$13K |
| E0730 |
Tens four lead |
190 |
190 |
$13K |
| A7002 |
Tubing used w suction pump |
2,728 |
1,980 |
$13K |
| E0971 |
Wheelchair anti-tipping devi |
2,212 |
2,200 |
$12K |
| E0105 |
Cane adjust/fixed quad/3 pro |
896 |
889 |
$12K |
| E0310 |
Rails bed side full length |
1,087 |
1,075 |
$11K |
| E0181 |
Press pad alternating w/ pum |
1,197 |
1,190 |
$10K |
| A6457 |
Tubular dressing |
254 |
247 |
$10K |
| A6454 |
Self-adher band w>=3" <5"/yd |
750 |
708 |
$9K |
| E0118 |
Crutch substitute |
5,663 |
1,530 |
$8K |
| K0005 |
Ultralightweight wheelchair |
39 |
36 |
$8K |
| L3809 |
Whfo w/o joints pre ots |
116 |
110 |
$8K |
| E0100 |
Cane adjust/fixed with tip |
1,360 |
1,353 |
$8K |
| E1226 |
Manual fully reclining back |
293 |
288 |
$8K |
| 94760 |
|
78 |
78 |
$8K |
| E0445 |
Oximeter non-invasive |
550 |
546 |
$8K |
| A4402 |
Lubricant per ounce |
1,147 |
1,099 |
$7K |
| E0635 |
Patient lift electric |
233 |
233 |
$7K |
| E1038 |
Transport chair pt wt<=300lb |
1,293 |
1,283 |
$7K |
| E0978 |
W/c acc,saf belt pelv strap |
1,767 |
1,747 |
$7K |
| E0776 |
Iv pole |
663 |
654 |
$7K |
| E0149 |
Heavy duty wheeled walker |
158 |
155 |
$6K |
| A7036 |
Pos airway press chinstrap |
1,209 |
1,203 |
$6K |
| E0466 |
Home vent non-invasive inter |
13 |
13 |
$6K |
| A4371 |
Skin barrier powder per oz |
2,430 |
2,355 |
$6K |
| A7015 |
Aerosol mask used w nebulize |
7,986 |
7,858 |
$5K |
| A7003 |
Nebulizer administration set |
7,900 |
7,804 |
$5K |
| A4450 |
Non-waterproof tape |
2,085 |
2,001 |
$5K |
| E0247 |
Trans bench w/wo comm open |
237 |
236 |
$5K |
| S1040 |
Cranial remolding orthosis |
16 |
16 |
$4K |
| A5056 |
1 pc ost pouch w filter |
77 |
75 |
$4K |
| T4543 |
Adult disp brief/diap abv xl |
52 |
51 |
$4K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
252 |
245 |
$4K |
| A4367 |
Ostomy belt |
1,027 |
1,000 |
$4K |
| A6260 |
Wound cleanser any type/size |
827 |
807 |
$4K |
| K0739 |
Repair/svc dme non-oxygen eq |
150 |
148 |
$3K |
| A4333 |
Urinary cath anchor device |
258 |
243 |
$3K |
| E1399 |
Durable medical equipment mi |
398 |
376 |
$3K |
| E0185 |
Gel pressure mattress pad |
263 |
258 |
$3K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
209 |
200 |
$3K |
| A4352 |
Coude tip urinary catheter |
24 |
24 |
$2K |
| E0156 |
Walker seat attachment |
753 |
745 |
$2K |
| A4247 |
Betadine/iodine swabs/wipes |
52 |
50 |
$2K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
57 |
55 |
$2K |
| A7039 |
Filter, non disposable w pap |
358 |
357 |
$2K |
| A6196 |
Alginate dressing <=16 sq in |
131 |
126 |
$2K |
| E0565 |
Compressor air power source |
117 |
117 |
$2K |
| A4455 |
Adhesive remover per ounce |
280 |
267 |
$1K |
| L3260 |
Ambulatory surgical boot eac |
38 |
38 |
$1K |
| A4253 |
Blood glucose/reagent strips |
220 |
219 |
$1K |
| E0244 |
Toilet seat raised |
38 |
38 |
$1K |
| A4259 |
Lancets per box |
169 |
168 |
$918.91 |
| L2820 |
Soft interface below knee se |
28 |
28 |
$878.59 |
| K0738 |
Portable gas oxygen system |
255 |
252 |
$850.03 |
| E0621 |
Patient lift sling or seat |
56 |
56 |
$834.96 |
| E0910 |
Trapeze bar attached to bed |
100 |
100 |
$627.51 |
| A7525 |
Tracheostomy mask |
507 |
454 |
$594.36 |
| A6219 |
Gauze <= 16 sq in w/border |
96 |
95 |
$564.97 |
| A6258 |
Transparent film >16<=48 in |
14 |
13 |
$253.96 |
| A6441 |
Pad band w>=3" <5"/yd |
12 |
12 |
$239.30 |
| E0245 |
Tub stool or bench |
13 |
13 |
$233.11 |
| L1902 |
Afo ankle gauntlet pre ots |
12 |
12 |
$217.92 |
| E0604 |
Hosp grade elec breast pump |
289 |
289 |
$159.65 |
| A4615 |
Cannula nasal |
663 |
541 |
$159.44 |
| A9900 |
Supply/accessory/service |
13 |
12 |
$156.54 |
| T4537 |
Reusable underpad bed size |
40 |
40 |
$102.77 |
| A6443 |
Conform band n/s w>=3"<5"/yd |
24 |
24 |
$97.02 |
| L1906 |
Afo multilig ank sup pre ots |
12 |
12 |
$96.56 |
| A7007 |
Lg vol nebulizer disposable |
55 |
51 |
$68.86 |
| E0561 |
Humidifier nonheated w pap |
1,749 |
1,660 |
$54.72 |
| A4322 |
Irrigation syringe |
13 |
13 |
$43.33 |
| A4245 |
Alcohol wipes per box |
56 |
53 |
$35.33 |
| A4332 |
Lube sterile packet |
13 |
13 |
$18.79 |
| A4616 |
Tubing (oxygen) per foot |
14 |
13 |
$0.83 |
| A4246 |
Betadine/phisohex solution |
42 |
40 |
$0.00 |
| A6449 |
Lt compres band >=3" <5"/yd |
12 |
12 |
$0.00 |