| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
49,151 |
42,245 |
$1.76M |
| L4361 |
Pneuma/vac walk boot pre ots |
3,897 |
3,694 |
$815K |
| A7030 |
Cpap full face mask |
14,733 |
13,549 |
$776K |
| E0601 |
Cont airway pressure device |
27,740 |
22,283 |
$590K |
| A4604 |
Tubing with heating element |
23,638 |
22,039 |
$578K |
| E0114 |
Crutch underarm pair no wood |
12,972 |
12,475 |
$474K |
| E0260 |
Hosp bed semi-electr w/ matt |
25,807 |
22,283 |
$471K |
| E0466 |
Home vent non-invasive inter |
1,450 |
1,102 |
$403K |
| A7031 |
Replacement facemask interfa |
17,405 |
15,618 |
$392K |
| L3809 |
Whfo w/o joints pre ots |
2,410 |
2,283 |
$355K |
| L3660 |
So 8 ab rstr can/web pre ots |
5,332 |
5,080 |
$351K |
| A7034 |
Nasal application device |
10,376 |
9,542 |
$348K |
| E0562 |
Humidifier heated used w pap |
9,708 |
9,039 |
$304K |
| L4350 |
Ankle control ortho pre ots |
3,466 |
3,333 |
$247K |
| B4035 |
Enteral feed supp pump per d |
2,611 |
2,286 |
$242K |
| K0001 |
Standard wheelchair |
23,912 |
21,193 |
$241K |
| E0603 |
Electric breast pump |
1,870 |
1,732 |
$235K |
| A7035 |
Pos airway press headgear |
17,026 |
15,850 |
$213K |
| L3908 |
Who cock-up nonmolde pre ots |
4,666 |
4,108 |
$207K |
| E0431 |
Portable gaseous 02 |
23,228 |
21,157 |
$203K |
| E0470 |
Rad w/o backup non-inv intfc |
4,467 |
3,288 |
$195K |
| E0465 |
Home vent invasive interface |
506 |
317 |
$176K |
| E0570 |
Nebulizer with compression |
9,989 |
8,941 |
$176K |
| K0738 |
Portable gas oxygen system |
10,308 |
9,022 |
$163K |
| E0143 |
Walker folding wheeled w/o s |
7,027 |
6,416 |
$155K |
| B4161 |
Ef ped hydrolyzed/amino acid |
467 |
385 |
$152K |
| A7032 |
Replacement nasal cushion |
8,081 |
7,106 |
$142K |
| L1830 |
Ko immob canvas long pre ots |
2,843 |
2,697 |
$141K |
| E0630 |
Patient lift hydraulic |
7,254 |
6,347 |
$124K |
| K0003 |
Lightweight wheelchair |
7,770 |
6,780 |
$110K |
| A7046 |
Repl water chamber, pap dev |
12,095 |
11,352 |
$99K |
| L3260 |
Ambulatory surgical boot eac |
3,971 |
3,763 |
$96K |
| E0247 |
Trans bench w/wo comm open |
867 |
796 |
$89K |
| E0163 |
Commode chair with fixed arm |
3,502 |
3,147 |
$87K |
| K0007 |
Extra heavy duty wheelchair |
1,794 |
1,580 |
$83K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
339 |
312 |
$82K |
| E1392 |
Portable oxygen concentrator |
6,311 |
5,658 |
$77K |
| A4623 |
Tracheostomy inner cannula |
594 |
525 |
$75K |
| K0006 |
Heavy duty wheelchair |
2,247 |
2,046 |
$73K |
| A4624 |
Tracheal suction tube |
838 |
710 |
$68K |
| E2611 |
Gen use back cush wdth <22in |
1,255 |
1,130 |
$68K |
| A7038 |
Pos airway pressure filter |
35,058 |
30,000 |
$66K |
| E0277 |
Powered pres-redu air mattrs |
1,244 |
1,044 |
$65K |
| A7033 |
Replacement nasal pillows |
4,574 |
4,028 |
$63K |
| E0600 |
Suction pump portab hom modl |
3,182 |
2,816 |
$62K |
| B4152 |
Ef calorie dense>/=1.5kcal |
943 |
802 |
$57K |
| B4150 |
Ef complet w/intact nutrient |
808 |
676 |
$56K |
| L1812 |
Ko elastic w/joints pre ots |
1,089 |
1,026 |
$56K |
| E0185 |
Gel pressure mattress pad |
1,042 |
925 |
$56K |
| K0195 |
Elevating whlchair leg rests |
11,187 |
9,777 |
$55K |
| A4629 |
Tracheostomy care kit |
750 |
625 |
$55K |
| B9998 |
Enteral supp not otherwise c |
2,613 |
1,627 |
$53K |
| E0303 |
Hosp bed hvy dty xtra wide |
1,046 |
894 |
$52K |
| A7526 |
Tracheostomy tube collar |
1,070 |
941 |
$47K |
| E0971 |
Wheelchair anti-tipping devi |
2,589 |
1,789 |
$39K |
| E0973 |
W/ch access det adj armrest |
1,426 |
960 |
$38K |
| L1833 |
Ko adj jnt pos r sup pre ots |
103 |
94 |
$36K |
| E0245 |
Tub stool or bench |
1,255 |
1,136 |
$34K |
| E2601 |
Gen w/c cushion wdth < 22 in |
2,323 |
1,976 |
$33K |
| E0118 |
Crutch substitute |
442 |
369 |
$31K |
| E0265 |
Hosp bed total electr w/ mat |
2,002 |
1,591 |
$30K |
| K0004 |
High strength ltwt whlchr |
1,252 |
1,107 |
$28K |
| B4034 |
Enter feed supkit syr by day |
806 |
700 |
$27K |
| E0240 |
Bath/shower chair |
194 |
181 |
$26K |
| E0165 |
Commode chair with detacharm |
2,255 |
2,015 |
$26K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
453 |
400 |
$25K |
| A7037 |
Pos airway pressure tubing |
3,242 |
2,843 |
$22K |
| E1028 |
W/c manual swingaway |
656 |
383 |
$18K |
| K0823 |
Pwc gp 2 std cap chair |
103 |
94 |
$18K |
| E0135 |
Walker folding adjust/fixed |
536 |
508 |
$16K |
| E0149 |
Heavy duty wheeled walker |
1,301 |
1,145 |
$15K |
| E0471 |
Rad w/backup non inv intrfc |
121 |
108 |
$15K |
| E0156 |
Walker seat attachment |
2,173 |
1,959 |
$14K |
| B9002 |
Enter nutr inf pump any type |
457 |
413 |
$13K |
| E0565 |
Compressor air power source |
827 |
565 |
$13K |
| B4088 |
Gastro/jejuno tube, low-pro |
565 |
517 |
$13K |
| E1226 |
Manual fully reclining back |
926 |
765 |
$13K |
| A4628 |
Oropharyngeal suction cath |
1,327 |
1,090 |
$13K |
| A7039 |
Filter, non disposable w pap |
2,911 |
2,731 |
$12K |
| A7520 |
Trach/laryn tube non-cuffed |
318 |
272 |
$12K |
| L1902 |
Afo ankle gauntlet pre ots |
195 |
183 |
$12K |
| E0961 |
Wheelchair brake extension |
1,142 |
817 |
$12K |
| E1038 |
Transport chair pt wt<=300lb |
2,350 |
2,066 |
$11K |
| A7005 |
Nondisposable nebulizer set |
1,455 |
1,297 |
$10K |
| A7000 |
Disposable canister for pump |
1,512 |
1,289 |
$10K |
| A4217 |
Sterile water/saline, 500 ml |
297 |
248 |
$10K |
| B4149 |
Ef blenderized foods |
68 |
54 |
$10K |
| A7507 |
Integrated filter & holder |
208 |
174 |
$9K |
| E0181 |
Press pad alternating w/ pum |
2,003 |
1,797 |
$9K |
| E0261 |
Hosp bed semi-electr w/o mat |
666 |
556 |
$9K |
| A7002 |
Tubing used w suction pump |
1,770 |
1,490 |
$9K |
| A7036 |
Pos airway press chinstrap |
1,283 |
1,216 |
$9K |
| E0951 |
Loop heel |
834 |
583 |
$5K |
| A4606 |
Oxygen probe used w oximeter |
163 |
136 |
$5K |
| B4153 |
Ef hydrolyzed/amino acids |
16 |
12 |
$4K |
| E0910 |
Trapeze bar attached to bed |
686 |
618 |
$3K |
| L4387 |
Non-pneum walk boot pre ots |
28 |
26 |
$3K |
| B4155 |
Ef incomplete/modular |
58 |
56 |
$2K |
| A7010 |
Disposable corrugated tubing |
131 |
118 |
$2K |
| E0776 |
Iv pole |
284 |
263 |
$2K |
| L3924 |
Hfo without joints pre ots |
41 |
32 |
$2K |
| E0271 |
Mattress innerspring |
667 |
556 |
$2K |
| A4927 |
Non-sterile gloves |
146 |
126 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
111 |
108 |
$1K |
| L4360 |
Pneumat walking boot pre cst |
14 |
12 |
$1K |
| E1020 |
Residual limb support system |
233 |
182 |
$1K |
| E0940 |
Trapeze bar free standing |
230 |
211 |
$1K |
| A4565 |
Slings |
198 |
189 |
$1K |
| A7007 |
Lg vol nebulizer disposable |
300 |
267 |
$1K |
| A4285 |
Replcmnt breast pump bottle |
100 |
94 |
$854.15 |
| A6402 |
Sterile gauze <= 16 sq in |
227 |
187 |
$845.96 |
| E0168 |
Heavyduty/wide commode chair |
20 |
18 |
$834.34 |
| A7015 |
Aerosol mask used w nebulize |
814 |
737 |
$681.93 |
| A7525 |
Tracheostomy mask |
309 |
282 |
$538.65 |
| A4216 |
Sterile water/saline, 10 ml |
113 |
96 |
$504.18 |
| A4450 |
Non-waterproof tape |
75 |
59 |
$469.35 |
| A7012 |
Nebulizer water collec devic |
167 |
147 |
$436.62 |
| A7013 |
Disposable compressor filter |
1,422 |
1,252 |
$430.83 |
| E0305 |
Rails bed side half length |
409 |
343 |
$381.11 |
| E0105 |
Cane adjust/fixed quad/3 pro |
17 |
13 |
$380.38 |
| E0621 |
Patient lift sling or seat |
15 |
14 |
$219.74 |
| E0705 |
Transfer device |
14 |
12 |
$116.28 |
| A4283 |
Replacement breastpump cap |
101 |
90 |
$60.47 |
| A7003 |
Nebulizer administration set |
59 |
51 |
$36.95 |
| A4282 |
Replacement breastpump adpt |
93 |
82 |
$23.34 |
| A4281 |
Replacement breastpump tube |
101 |
90 |
$21.60 |
| A4286 |
Replcmnt breastpump lok ring |
101 |
90 |
$13.20 |
| A4284 |
Replcmnt breast pump shield |
101 |
90 |
$13.20 |