| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
47,767 |
44,619 |
$4.73M |
| E0465 |
Home vent invasive interface |
3,702 |
3,121 |
$2.42M |
| E0601 |
Cont airway pressure device |
40,415 |
37,756 |
$2.17M |
| B4035 |
Enteral feed supp pump per d |
6,988 |
6,607 |
$1.65M |
| A4624 |
Tracheal suction tube |
5,767 |
5,334 |
$1.09M |
| E0466 |
Home vent non-invasive inter |
1,825 |
1,751 |
$953K |
| A7030 |
Cpap full face mask |
9,364 |
8,889 |
$831K |
| E0562 |
Humidifier heated used w pap |
30,074 |
27,463 |
$804K |
| B4161 |
Ef ped hydrolyzed/amino acid |
941 |
875 |
$790K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,182 |
2,020 |
$619K |
| A7507 |
Integrated filter & holder |
4,954 |
4,708 |
$601K |
| E0431 |
Portable gaseous 02 |
32,559 |
30,323 |
$566K |
| E0603 |
Electric breast pump |
5,222 |
4,939 |
$547K |
| E0470 |
Rad w/o backup non-inv intfc |
3,610 |
3,359 |
$505K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,831 |
2,528 |
$441K |
| A4604 |
Tubing with heating element |
14,770 |
13,961 |
$429K |
| B4150 |
Ef complet w/intact nutrient |
2,772 |
2,482 |
$426K |
| A7526 |
Tracheostomy tube collar |
6,793 |
6,413 |
$424K |
| A4629 |
Tracheostomy care kit |
4,257 |
4,021 |
$416K |
| A9900 |
Supply/accessory/service |
1,251 |
1,101 |
$414K |
| A7034 |
Nasal application device |
7,078 |
6,700 |
$376K |
| K0001 |
Standard wheelchair |
11,217 |
10,028 |
$373K |
| A7520 |
Trach/laryn tube non-cuffed |
4,721 |
4,433 |
$367K |
| T4541 |
Large disposable underpad |
5,482 |
5,209 |
$359K |
| B4149 |
Ef blenderized foods |
757 |
698 |
$309K |
| E0260 |
Hosp bed semi-electr w/ matt |
6,389 |
6,099 |
$275K |
| A7035 |
Pos airway press headgear |
12,147 |
11,423 |
$259K |
| A7031 |
Replacement facemask interfa |
7,625 |
7,348 |
$234K |
| B4036 |
Enteral feed sup kit grav by |
1,689 |
1,556 |
$215K |
| A4623 |
Tracheostomy inner cannula |
1,899 |
1,752 |
$215K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,893 |
1,810 |
$213K |
| K0738 |
Portable gas oxygen system |
6,476 |
6,107 |
$199K |
| A7032 |
Replacement nasal cushion |
5,901 |
5,580 |
$183K |
| E0570 |
Nebulizer with compression |
4,460 |
4,304 |
$143K |
| A7038 |
Pos airway pressure filter |
26,250 |
24,652 |
$137K |
| E0600 |
Suction pump portab hom modl |
5,613 |
5,297 |
$132K |
| A7046 |
Repl water chamber, pap dev |
10,969 |
10,247 |
$130K |
| B4034 |
Enter feed supkit syr by day |
1,587 |
1,475 |
$124K |
| A4605 |
Trach suction cath close sys |
330 |
314 |
$108K |
| A7521 |
Trach/laryn tube cuffed |
1,436 |
1,369 |
$106K |
| T4535 |
Disposable liner/shield/pad |
2,424 |
2,281 |
$100K |
| A7033 |
Replacement nasal pillows |
4,184 |
3,952 |
$97K |
| T4522 |
Adult size brief/diaper med |
992 |
930 |
$96K |
| T4527 |
Adult size pull-on lg |
1,088 |
1,021 |
$91K |
| A4927 |
Non-sterile gloves |
6,930 |
6,539 |
$91K |
| E0630 |
Patient lift hydraulic |
2,010 |
1,927 |
$89K |
| T4526 |
Adult size pull-on med |
928 |
877 |
$88K |
| A7000 |
Disposable canister for pump |
7,365 |
6,980 |
$88K |
| B9002 |
Enter nutr inf pump any type |
1,402 |
1,209 |
$84K |
| E0443 |
Portable 02 contents, gas |
1,251 |
1,175 |
$84K |
| T4523 |
Adult size brief/diaper lg |
628 |
575 |
$68K |
| B4154 |
Ef spec metabolic noninherit |
258 |
212 |
$67K |
| E1392 |
Portable oxygen concentrator |
3,234 |
2,929 |
$61K |
| E2402 |
Neg press wound therapy pump |
719 |
55 |
$60K |
| T4528 |
Adult size pull-on xl |
501 |
471 |
$53K |
| K0003 |
Lightweight wheelchair |
1,140 |
1,077 |
$52K |
| E0565 |
Compressor air power source |
1,695 |
1,558 |
$52K |
| E0143 |
Walker folding wheeled w/o s |
789 |
755 |
$44K |
| A4649 |
Surgical supplies |
1,562 |
1,453 |
$44K |
| A6402 |
Sterile gauze <= 16 sq in |
3,253 |
3,012 |
$43K |
| E1226 |
Manual fully reclining back |
523 |
465 |
$40K |
| A4670 |
Automatic bp monitor, dial |
642 |
585 |
$38K |
| T4530 |
Ped size brief/diaper lg |
345 |
331 |
$38K |
| A7002 |
Tubing used w suction pump |
7,100 |
6,740 |
$37K |
| A7005 |
Nondisposable nebulizer set |
1,812 |
1,657 |
$32K |
| A7018 |
Water distilled w/nebulizer |
4,849 |
4,602 |
$27K |
| E0114 |
Crutch underarm pair no wood |
803 |
756 |
$24K |
| A7037 |
Pos airway pressure tubing |
1,098 |
1,034 |
$22K |
| A7039 |
Filter, non disposable w pap |
2,348 |
2,182 |
$17K |
| A7003 |
Nebulizer administration set |
5,028 |
4,745 |
$17K |
| E0776 |
Iv pole |
2,931 |
2,589 |
$14K |
| A4628 |
Oropharyngeal suction cath |
4,382 |
4,140 |
$9K |
| E0163 |
Commode chair with fixed arm |
144 |
136 |
$9K |
| E0277 |
Powered pres-redu air mattrs |
55 |
50 |
$8K |
| A4402 |
Lubricant per ounce |
2,013 |
1,895 |
$7K |
| A4452 |
Waterproof tape |
1,044 |
993 |
$7K |
| A7525 |
Tracheostomy mask |
4,203 |
3,997 |
$7K |
| E0471 |
Rad w/backup non inv intrfc |
25 |
25 |
$6K |
| E0971 |
Wheelchair anti-tipping devi |
1,540 |
1,033 |
$6K |
| A7007 |
Lg vol nebulizer disposable |
1,655 |
1,541 |
$6K |
| K0195 |
Elevating whlchair leg rests |
1,339 |
1,295 |
$3K |
| T4532 |
Ped size pull-on lg |
50 |
37 |
$3K |
| A4450 |
Non-waterproof tape |
1,411 |
1,341 |
$3K |
| A4322 |
Irrigation syringe |
418 |
406 |
$3K |
| A7012 |
Nebulizer water collec devic |
701 |
645 |
$3K |
| A4213 |
20+ cc syringe only |
494 |
462 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,627 |
1,494 |
$2K |
| B4155 |
Ef incomplete/modular |
112 |
108 |
$2K |
| A7013 |
Disposable compressor filter |
2,261 |
2,123 |
$1K |
| B9998 |
Enteral supp not otherwise c |
56 |
52 |
$1K |
| A7010 |
Disposable corrugated tubing |
71 |
68 |
$1K |
| T4534 |
Youth size pull-on |
13 |
12 |
$1K |
| A7036 |
Pos airway press chinstrap |
35 |
33 |
$320.61 |