| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
7,602 |
5,424 |
$3.75M |
| E1390 |
Oxygen concentrator |
41,441 |
38,695 |
$2.34M |
| E0601 |
Cont airway pressure device |
41,174 |
39,554 |
$2.26M |
| B4035 |
Enteral feed supp pump per d |
15,262 |
12,923 |
$2.24M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
8,969 |
6,922 |
$1.57M |
| B4152 |
Ef calorie dense>/=1.5kcal |
12,250 |
8,741 |
$1.44M |
| B9998 |
Enteral supp not otherwise c |
18,946 |
12,525 |
$1.39M |
| B4153 |
Ef hydrolyzed/amino acids |
2,774 |
1,929 |
$1.26M |
| E0465 |
Home vent invasive interface |
2,849 |
2,060 |
$1.21M |
| E0570 |
Nebulizer with compression |
35,357 |
33,327 |
$1.01M |
| E0562 |
Humidifier heated used w pap |
17,692 |
16,651 |
$1.00M |
| E0603 |
Electric breast pump |
4,737 |
4,611 |
$820K |
| B4149 |
Ef blenderized foods |
2,766 |
1,955 |
$810K |
| E0431 |
Portable gaseous 02 |
32,470 |
30,448 |
$680K |
| B4150 |
Ef complet w/intact nutrient |
6,480 |
4,855 |
$631K |
| A4670 |
Automatic bp monitor, dial |
16,677 |
16,151 |
$614K |
| E0470 |
Rad w/o backup non-inv intfc |
4,796 |
4,562 |
$603K |
| E0260 |
Hosp bed semi-electr w/ matt |
11,338 |
10,598 |
$597K |
| A7030 |
Cpap full face mask |
8,526 |
8,124 |
$519K |
| L4360 |
Pneumat walking boot pre cst |
3,969 |
3,793 |
$515K |
| K0001 |
Standard wheelchair |
14,266 |
13,447 |
$493K |
| E0143 |
Walker folding wheeled w/o s |
13,845 |
13,133 |
$475K |
| B4088 |
Gastro/jejuno tube, low-pro |
5,059 |
4,648 |
$471K |
| B4154 |
Ef spec metabolic noninherit |
2,052 |
1,589 |
$368K |
| T4534 |
Youth size pull-on |
4,009 |
3,778 |
$357K |
| T4541 |
Large disposable underpad |
9,983 |
9,366 |
$348K |
| T4528 |
Adult size pull-on xl |
3,128 |
2,960 |
$342K |
| K0003 |
Lightweight wheelchair |
5,210 |
4,909 |
$333K |
| L3908 |
Who cock-up nonmolde pre ots |
9,319 |
7,459 |
$326K |
| B9002 |
Enter nutr inf pump any type |
4,784 |
4,621 |
$302K |
| T4527 |
Adult size pull-on lg |
3,321 |
3,071 |
$300K |
| T4526 |
Adult size pull-on med |
3,034 |
2,858 |
$290K |
| E0471 |
Rad w/backup non inv intrfc |
1,261 |
1,166 |
$285K |
| E0445 |
Oximeter non-invasive |
1,411 |
1,325 |
$284K |
| A7034 |
Nasal application device |
7,543 |
7,141 |
$284K |
| A7035 |
Pos airway press headgear |
13,863 |
13,067 |
$279K |
| A6530 |
Compression stocking bk18-30 |
5,286 |
4,179 |
$258K |
| T4522 |
Adult size brief/diaper med |
2,387 |
2,118 |
$248K |
| T4535 |
Disposable liner/shield/pad |
5,597 |
5,213 |
$243K |
| L4361 |
Pneuma/vac walk boot pre ots |
1,950 |
1,806 |
$224K |
| A7037 |
Pos airway pressure tubing |
13,570 |
12,942 |
$207K |
| L3807 |
Whfo w/o joints pre cst |
1,633 |
1,485 |
$188K |
| E0114 |
Crutch underarm pair no wood |
8,967 |
8,645 |
$181K |
| E0245 |
Tub stool or bench |
5,440 |
5,159 |
$178K |
| B4034 |
Enter feed supkit syr by day |
3,114 |
2,627 |
$175K |
| L3809 |
Whfo w/o joints pre ots |
1,565 |
1,375 |
$174K |
| T4523 |
Adult size brief/diaper lg |
1,584 |
1,409 |
$151K |
| B4155 |
Ef incomplete/modular |
2,873 |
2,019 |
$150K |
| L4350 |
Ankle control ortho pre ots |
2,805 |
2,720 |
$146K |
| T4525 |
Adult size pull-on sm |
1,455 |
1,372 |
$138K |
| A4351 |
Straight tip urine catheter |
1,714 |
1,590 |
$138K |
| A6533 |
Gc stocking thighlngth 18-30 |
2,360 |
1,862 |
$137K |
| A4624 |
Tracheal suction tube |
2,436 |
2,103 |
$130K |
| B4036 |
Enteral feed sup kit grav by |
1,367 |
1,181 |
$122K |
| E0630 |
Patient lift hydraulic |
1,570 |
1,481 |
$118K |
| E0600 |
Suction pump portab hom modl |
1,637 |
1,466 |
$117K |
| B4100 |
Food thickener oral |
1,186 |
972 |
$117K |
| A4927 |
Non-sterile gloves |
8,971 |
8,208 |
$113K |
| E0247 |
Trans bench w/wo comm open |
1,646 |
1,570 |
$98K |
| E0163 |
Commode chair with fixed arm |
2,873 |
2,713 |
$97K |
| A7520 |
Trach/laryn tube non-cuffed |
1,367 |
1,232 |
$97K |
| E0149 |
Heavy duty wheeled walker |
4,155 |
3,854 |
$96K |
| A4483 |
Moisture exchanger |
632 |
562 |
$94K |
| T4532 |
Ped size pull-on lg |
1,054 |
1,015 |
$90K |
| E0990 |
Wheelchair elevating leg res |
3,886 |
3,632 |
$85K |
| A4623 |
Tracheostomy inner cannula |
1,288 |
1,098 |
$84K |
| A7521 |
Trach/laryn tube cuffed |
1,005 |
680 |
$83K |
| L1902 |
Afo ankle gauntlet pre ots |
2,254 |
2,068 |
$80K |
| T4524 |
Adult size brief/diaper xl |
756 |
708 |
$80K |
| L1810 |
Ko elastic with joints |
1,570 |
1,234 |
$78K |
| A7526 |
Tracheostomy tube collar |
2,983 |
2,608 |
$77K |
| T4544 |
Adlt disp und/pull on abv xl |
353 |
338 |
$75K |
| A7031 |
Replacement facemask interfa |
3,897 |
3,710 |
$73K |
| K0006 |
Heavy duty wheelchair |
771 |
734 |
$72K |
| A4629 |
Tracheostomy care kit |
1,921 |
1,664 |
$72K |
| E0244 |
Toilet seat raised |
1,674 |
1,601 |
$70K |
| E0277 |
Powered pres-redu air mattrs |
248 |
244 |
$68K |
| E1238 |
Fld ped wc adjstabl w/o seat |
454 |
434 |
$66K |
| L1820 |
Ko elas w/ condyle pads & jo |
1,032 |
890 |
$66K |
| L1830 |
Ko immob canvas long pre ots |
1,533 |
1,457 |
$65K |
| A6549 |
Grad com garm noc day use |
163 |
117 |
$63K |
| T4530 |
Ped size brief/diaper lg |
711 |
639 |
$58K |
| E0156 |
Walker seat attachment |
5,837 |
5,566 |
$52K |
| A7005 |
Nondisposable nebulizer set |
3,541 |
3,328 |
$52K |
| E0424 |
Stationary compressed gas 02 |
554 |
542 |
$51K |
| E0619 |
Apnea monitor w recorder |
197 |
193 |
$51K |
| E0303 |
Hosp bed hvy dty xtra wide |
304 |
295 |
$47K |
| E0971 |
Wheelchair anti-tipping devi |
3,956 |
2,718 |
$47K |
| A4604 |
Tubing with heating element |
1,672 |
1,589 |
$45K |
| K0195 |
Elevating whlchair leg rests |
5,678 |
5,279 |
$43K |
| A7000 |
Disposable canister for pump |
4,259 |
3,825 |
$43K |
| T4533 |
Youth size brief/diaper |
434 |
416 |
$40K |
| A6402 |
Sterile gauze <= 16 sq in |
4,345 |
3,826 |
$35K |
| E0135 |
Walker folding adjust/fixed |
915 |
869 |
$32K |
| T4537 |
Reusable underpad bed size |
321 |
305 |
$32K |
| E1236 |
Folding ped wc adjustable |
172 |
164 |
$30K |
| A4467 |
Belt strap sleev grmnt cover |
1,497 |
1,379 |
$30K |
| A7038 |
Pos airway pressure filter |
16,191 |
14,734 |
$30K |
| E1392 |
Portable oxygen concentrator |
2,473 |
2,365 |
$30K |
| E0165 |
Commode chair with detacharm |
1,333 |
1,259 |
$29K |
| E0100 |
Cane adjust/fixed with tip |
3,834 |
3,648 |
$29K |
| A7002 |
Tubing used w suction pump |
4,731 |
3,909 |
$24K |
| L1812 |
Ko elastic w/joints pre ots |
580 |
459 |
$22K |
| A4565 |
Slings |
4,209 |
3,855 |
$21K |
| A7036 |
Pos airway press chinstrap |
2,103 |
2,023 |
$20K |
| A4217 |
Sterile water/saline, 500 ml |
397 |
342 |
$19K |
| A4628 |
Oropharyngeal suction cath |
2,988 |
2,559 |
$19K |
| A6539 |
Gc stocking waistlngth 18-30 |
325 |
262 |
$19K |
| A7003 |
Nebulizer administration set |
8,698 |
7,430 |
$18K |
| A7033 |
Replacement nasal pillows |
1,411 |
1,329 |
$18K |
| E0978 |
W/c acc,saf belt pelv strap |
2,697 |
2,485 |
$15K |
| K0823 |
Pwc gp 2 std cap chair |
70 |
62 |
$14K |
| A7032 |
Replacement nasal cushion |
1,027 |
969 |
$14K |
| L0621 |
Sio flex pelvic/sacr pre ots |
279 |
263 |
$13K |
| E0105 |
Cane adjust/fixed quad/3 pro |
656 |
623 |
$13K |
| E1038 |
Transport chair pt wt<=300lb |
808 |
786 |
$11K |
| E2601 |
Gen w/c cushion wdth < 22 in |
259 |
241 |
$10K |
| L4396 |
Static or dynami afo pre cst |
122 |
112 |
$10K |
| L2795 |
Knee control full kneecap |
231 |
199 |
$10K |
| L4397 |
Static or dynami afo pre ots |
131 |
116 |
$9K |
| A7015 |
Aerosol mask used w nebulize |
6,569 |
5,581 |
$8K |
| E0776 |
Iv pole |
855 |
790 |
$8K |
| B4082 |
Enteral ng tubing w/o stylet |
458 |
287 |
$8K |
| E0565 |
Compressor air power source |
154 |
147 |
$6K |
| A4357 |
Bedside drainage bag |
1,066 |
885 |
$5K |
| E0185 |
Gel pressure mattress pad |
308 |
293 |
$5K |
| E0240 |
Bath/shower chair |
132 |
124 |
$4K |
| T4531 |
Ped size pull-on sm/med |
49 |
39 |
$4K |
| E2611 |
Gen use back cush wdth <22in |
17 |
15 |
$4K |
| E0181 |
Press pad alternating w/ pum |
200 |
184 |
$4K |
| A7046 |
Repl water chamber, pap dev |
2,250 |
2,106 |
$4K |
| E0973 |
W/ch access det adj armrest |
188 |
93 |
$3K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
24 |
24 |
$3K |
| E1226 |
Manual fully reclining back |
58 |
54 |
$3K |
| A6531 |
Compress stking bk30-40 surg |
66 |
42 |
$3K |
| K0739 |
Repair/svc dme non-oxygen eq |
101 |
92 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
12 |
12 |
$2K |
| T4529 |
Ped size brief/diaper sm/med |
43 |
40 |
$2K |
| E0241 |
Bath tub wall rail |
74 |
72 |
$1K |
| A7039 |
Filter, non disposable w pap |
258 |
235 |
$1K |
| S8424 |
Ready gradient sleeve |
30 |
26 |
$1K |
| A4450 |
Non-waterproof tape |
271 |
236 |
$948.35 |
| A7525 |
Tracheostomy mask |
871 |
452 |
$893.98 |
| L3924 |
Hfo without joints pre ots |
18 |
12 |
$742.78 |
| A4358 |
Urinary leg or abdomen bag |
114 |
73 |
$712.36 |
| E0168 |
Heavyduty/wide commode chair |
12 |
12 |
$691.52 |
| A5063 |
Drain ostomy pouch w/flange |
52 |
50 |
$548.04 |
| A6216 |
Non-sterile gauze<=16 sq in |
831 |
768 |
$544.70 |
| A6446 |
Conform band s w>=3" <5"/yd |
15 |
15 |
$506.20 |
| A4349 |
Disposable male external cat |
14 |
13 |
$428.87 |
| E0184 |
Dry pressure mattress |
17 |
17 |
$255.00 |
| A4570 |
Splint |
26 |
26 |
$247.00 |
| A4452 |
Waterproof tape |
18 |
14 |
$204.09 |
| A4310 |
Insert tray w/o bag/cath |
100 |
76 |
$139.90 |
| A7007 |
Lg vol nebulizer disposable |
32 |
24 |
$129.45 |
| A4402 |
Lubricant per ounce |
26 |
24 |
$68.58 |
| A4338 |
Indwelling catheter latex |
31 |
25 |
$44.85 |
| A5120 |
Skin barrier, wipe or swab |
14 |
12 |
$34.00 |
| A7012 |
Nebulizer water collec devic |
12 |
12 |
$22.50 |