| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
23,826 |
21,528 |
$1.10M |
| E1390 |
Oxygen concentrator |
21,266 |
18,229 |
$1.07M |
| A7030 |
Cpap full face mask |
8,921 |
8,178 |
$811K |
| E0562 |
Humidifier heated used w pap |
20,645 |
18,385 |
$493K |
| A7034 |
Nasal application device |
6,324 |
5,762 |
$397K |
| E0431 |
Portable gaseous 02 |
14,868 |
12,628 |
$320K |
| A7035 |
Pos airway press headgear |
14,050 |
12,798 |
$313K |
| A7037 |
Pos airway pressure tubing |
12,959 |
12,151 |
$288K |
| B4035 |
Enteral feed supp pump per d |
3,203 |
2,269 |
$265K |
| A7031 |
Replacement facemask interfa |
6,185 |
5,579 |
$200K |
| L3908 |
Who cock-up nonmolde pre ots |
4,710 |
3,964 |
$181K |
| L4387 |
Non-pneum walk boot pre ots |
2,424 |
2,188 |
$166K |
| E0114 |
Crutch underarm pair no wood |
4,145 |
3,853 |
$153K |
| E0470 |
Rad w/o backup non-inv intfc |
2,234 |
1,979 |
$125K |
| B4150 |
Ef complet w/intact nutrient |
1,525 |
1,179 |
$122K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,448 |
1,237 |
$115K |
| B4149 |
Ef blenderized foods |
646 |
275 |
$108K |
| E0471 |
Rad w/backup non inv intrfc |
698 |
633 |
$102K |
| E0570 |
Nebulizer with compression |
7,110 |
6,327 |
$92K |
| L4350 |
Ankle control ortho pre ots |
1,633 |
1,510 |
$87K |
| A7038 |
Pos airway pressure filter |
15,881 |
14,410 |
$72K |
| E0143 |
Walker folding wheeled w/o s |
2,243 |
2,049 |
$58K |
| E0118 |
Crutch substitute |
1,733 |
1,573 |
$58K |
| A7046 |
Repl water chamber, pap dev |
6,718 |
6,190 |
$48K |
| B4152 |
Ef calorie dense>/=1.5kcal |
450 |
326 |
$46K |
| B9002 |
Enter nutr inf pump any type |
1,135 |
914 |
$43K |
| A4606 |
Oxygen probe used w oximeter |
2,077 |
440 |
$38K |
| E0443 |
Portable 02 contents, gas |
2,554 |
1,370 |
$37K |
| A7005 |
Nondisposable nebulizer set |
3,035 |
2,815 |
$37K |
| A7032 |
Replacement nasal cushion |
2,491 |
2,263 |
$33K |
| K0001 |
Standard wheelchair |
3,570 |
3,110 |
$30K |
| L1830 |
Ko immob canvas long pre ots |
662 |
594 |
$26K |
| A4385 |
Ost skn barrier sld ext wear |
775 |
627 |
$25K |
| A4409 |
Ost skn barr convex <=4 sq i |
561 |
468 |
$25K |
| E0603 |
Electric breast pump |
158 |
145 |
$23K |
| K0006 |
Heavy duty wheelchair |
773 |
722 |
$20K |
| A4407 |
Ext wear ost skn barr <=4sq" |
393 |
360 |
$20K |
| A5063 |
Drain ostomy pouch w/flange |
854 |
788 |
$20K |
| A6402 |
Sterile gauze <= 16 sq in |
2,581 |
2,091 |
$16K |
| A4604 |
Tubing with heating element |
2,220 |
2,120 |
$16K |
| L4361 |
Pneuma/vac walk boot pre ots |
141 |
126 |
$15K |
| K0003 |
Lightweight wheelchair |
770 |
665 |
$15K |
| E0260 |
Hosp bed semi-electr w/ matt |
941 |
825 |
$14K |
| A7033 |
Replacement nasal pillows |
810 |
722 |
$11K |
| B4036 |
Enteral feed sup kit grav by |
198 |
150 |
$10K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
69 |
60 |
$9K |
| E0600 |
Suction pump portab hom modl |
496 |
394 |
$8K |
| K0002 |
Stnd hemi (low seat) whlchr |
681 |
608 |
$8K |
| L1812 |
Ko elastic w/joints pre ots |
186 |
133 |
$7K |
| A4425 |
Ost pch drain for barrier fl |
240 |
221 |
$6K |
| E0250 |
Hosp bed fixed ht w/ mattres |
334 |
308 |
$6K |
| L1902 |
Afo ankle gauntlet pre ots |
164 |
140 |
$6K |
| A4213 |
20+ cc syringe only |
1,129 |
875 |
$5K |
| A4322 |
Irrigation syringe |
486 |
331 |
$4K |
| A6212 |
Foam drg <=16 sq in w/border |
78 |
56 |
$4K |
| A4452 |
Waterproof tape |
759 |
633 |
$3K |
| E0156 |
Walker seat attachment |
367 |
320 |
$3K |
| A4927 |
Non-sterile gloves |
498 |
388 |
$3K |
| A5120 |
Skin barrier, wipe or swab |
1,313 |
804 |
$3K |
| B9998 |
Enteral supp not otherwise c |
2,055 |
1,584 |
$3K |
| A7018 |
Water distilled w/nebulizer |
103 |
79 |
$2K |
| E0202 |
Phototherapy light w/ photom |
31 |
26 |
$2K |
| A4627 |
Spacer bag/reservoir |
126 |
114 |
$2K |
| A7027 |
Combination oral/nasal mask |
13 |
12 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
117 |
91 |
$2K |
| A9900 |
Supply/accessory/service |
2,408 |
1,745 |
$1K |
| A6530 |
Compression stocking bk18-30 |
58 |
26 |
$1K |
| A4456 |
Adhesive remover, wipes |
226 |
217 |
$1K |
| A4450 |
Non-waterproof tape |
436 |
377 |
$1K |
| A7002 |
Tubing used w suction pump |
205 |
146 |
$1K |
| K0195 |
Elevating whlchair leg rests |
746 |
668 |
$1K |
| A7003 |
Nebulizer administration set |
1,608 |
1,357 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
950 |
784 |
$962.80 |
| E0445 |
Oximeter non-invasive |
27 |
25 |
$959.46 |
| A4624 |
Tracheal suction tube |
16 |
12 |
$791.47 |
| E0255 |
Hospital bed var ht w/ mattr |
42 |
39 |
$720.91 |
| E0630 |
Patient lift hydraulic |
26 |
26 |
$690.04 |
| A4357 |
Bedside drainage bag |
173 |
142 |
$672.97 |
| K0738 |
Portable gas oxygen system |
154 |
139 |
$581.39 |
| A4615 |
Cannula nasal |
1,090 |
439 |
$543.33 |
| A4362 |
Solid skin barrier |
20 |
12 |
$505.28 |
| A4394 |
Ostomy pouch liq deodorant |
60 |
50 |
$362.99 |
| A4616 |
Tubing (oxygen) per foot |
249 |
180 |
$281.40 |
| A4628 |
Oropharyngeal suction cath |
59 |
37 |
$230.34 |
| A7039 |
Filter, non disposable w pap |
41 |
38 |
$167.89 |
| A4358 |
Urinary leg or abdomen bag |
27 |
24 |
$79.96 |
| E2601 |
Gen w/c cushion wdth < 22 in |
13 |
12 |
$59.76 |
| A4626 |
Tracheostomy cleaning brush |
19 |
13 |
$0.12 |