| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
14,216 |
14,204 |
$1.32M |
| E0465 |
Home vent invasive interface |
538 |
534 |
$464K |
| E0601 |
Cont airway pressure device |
8,346 |
8,329 |
$449K |
| A7030 |
Cpap full face mask |
3,444 |
3,434 |
$369K |
| E0562 |
Humidifier heated used w pap |
2,121 |
2,109 |
$285K |
| E0470 |
Rad w/o backup non-inv intfc |
2,058 |
2,053 |
$256K |
| E0471 |
Rad w/backup non inv intrfc |
766 |
764 |
$223K |
| A4604 |
Tubing with heating element |
4,928 |
4,917 |
$212K |
| E1399 |
Durable medical equipment mi |
100 |
88 |
$184K |
| E0603 |
Electric breast pump |
1,403 |
1,403 |
$183K |
| A4351 |
Straight tip urine catheter |
896 |
799 |
$182K |
| T4526 |
Adult size pull-on med |
1,902 |
1,883 |
$172K |
| E0570 |
Nebulizer with compression |
15,268 |
15,238 |
$170K |
| E0466 |
Home vent non-invasive inter |
240 |
240 |
$168K |
| A7031 |
Replacement facemask interfa |
3,733 |
3,702 |
$159K |
| T4534 |
Youth size pull-on |
2,089 |
2,033 |
$150K |
| E0431 |
Portable gaseous 02 |
7,621 |
7,615 |
$144K |
| A7034 |
Nasal application device |
2,055 |
2,052 |
$139K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,210 |
884 |
$138K |
| T4527 |
Adult size pull-on lg |
1,423 |
1,406 |
$136K |
| E0600 |
Suction pump portab hom modl |
2,589 |
2,571 |
$118K |
| T4522 |
Adult size brief/diaper med |
1,085 |
1,076 |
$100K |
| B4149 |
Ef blenderized foods |
347 |
217 |
$82K |
| E1392 |
Portable oxygen concentrator |
2,691 |
2,691 |
$78K |
| E0439 |
Stationary liquid 02 |
862 |
859 |
$77K |
| A7035 |
Pos airway press headgear |
3,439 |
3,432 |
$76K |
| T4528 |
Adult size pull-on xl |
711 |
707 |
$76K |
| E0424 |
Stationary compressed gas 02 |
1,065 |
1,064 |
$75K |
| T4530 |
Ped size brief/diaper lg |
846 |
830 |
$69K |
| A7032 |
Replacement nasal cushion |
1,456 |
1,441 |
$67K |
| T4535 |
Disposable liner/shield/pad |
1,900 |
1,866 |
$67K |
| A4217 |
Sterile water/saline, 500 ml |
550 |
452 |
$65K |
| B4161 |
Ef ped hydrolyzed/amino acid |
160 |
147 |
$63K |
| T4523 |
Adult size brief/diaper lg |
614 |
609 |
$63K |
| T4541 |
Large disposable underpad |
2,812 |
2,767 |
$61K |
| E0445 |
Oximeter non-invasive |
627 |
622 |
$60K |
| E0202 |
Phototherapy light w/ photom |
111 |
83 |
$60K |
| K0001 |
Standard wheelchair |
2,064 |
2,058 |
$58K |
| A4927 |
Non-sterile gloves |
3,868 |
3,789 |
$56K |
| E0143 |
Walker folding wheeled w/o s |
955 |
952 |
$55K |
| A4624 |
Tracheal suction tube |
618 |
569 |
$47K |
| E0260 |
Hosp bed semi-electr w/ matt |
585 |
585 |
$42K |
| T4521 |
Adult size brief/diaper sm |
481 |
472 |
$41K |
| A7005 |
Nondisposable nebulizer set |
2,328 |
2,322 |
$40K |
| A7038 |
Pos airway pressure filter |
6,558 |
6,506 |
$39K |
| A4409 |
Ost skn barr convex <=4 sq i |
406 |
391 |
$39K |
| B4035 |
Enteral feed supp pump per d |
377 |
363 |
$35K |
| A7507 |
Integrated filter & holder |
386 |
347 |
$35K |
| T4525 |
Adult size pull-on sm |
515 |
509 |
$34K |
| T4537 |
Reusable underpad bed size |
1,229 |
1,222 |
$32K |
| E0240 |
Bath/shower chair |
465 |
465 |
$30K |
| A7000 |
Disposable canister for pump |
1,474 |
1,439 |
$29K |
| A4605 |
Trach suction cath close sys |
338 |
325 |
$28K |
| E0483 |
Hi freq chest wall oscil sys |
27 |
27 |
$27K |
| K0108 |
W/c component-accessory nos |
109 |
94 |
$26K |
| A7046 |
Repl water chamber, pap dev |
2,068 |
2,059 |
$25K |
| A7526 |
Tracheostomy tube collar |
504 |
466 |
$25K |
| T4544 |
Adlt disp und/pull on abv xl |
113 |
108 |
$25K |
| T4532 |
Ped size pull-on lg |
291 |
289 |
$23K |
| B4150 |
Ef complet w/intact nutrient |
251 |
184 |
$22K |
| A4385 |
Ost skn barrier sld ext wear |
286 |
271 |
$22K |
| E0434 |
Portable liquid 02 |
726 |
723 |
$19K |
| A4357 |
Bedside drainage bag |
1,036 |
500 |
$16K |
| A7033 |
Replacement nasal pillows |
373 |
372 |
$14K |
| A7002 |
Tubing used w suction pump |
1,624 |
1,572 |
$14K |
| K0007 |
Extra heavy duty wheelchair |
98 |
97 |
$13K |
| A4322 |
Irrigation syringe |
263 |
246 |
$13K |
| E0442 |
Stationary o2 contents, liq |
211 |
211 |
$12K |
| A4407 |
Ext wear ost skn barr <=4sq" |
100 |
95 |
$11K |
| A4628 |
Oropharyngeal suction cath |
1,420 |
1,250 |
$11K |
| A4629 |
Tracheostomy care kit |
110 |
102 |
$11K |
| K0195 |
Elevating whlchair leg rests |
795 |
791 |
$11K |
| A4606 |
Oxygen probe used w oximeter |
1,715 |
840 |
$11K |
| E1236 |
Folding ped wc adjustable |
43 |
43 |
$11K |
| A5063 |
Drain ostomy pouch w/flange |
224 |
208 |
$11K |
| E0630 |
Patient lift hydraulic |
212 |
209 |
$10K |
| K0004 |
High strength ltwt whlchr |
124 |
124 |
$10K |
| A7520 |
Trach/laryn tube non-cuffed |
306 |
292 |
$10K |
| L1820 |
Ko elas w/ condyle pads & jo |
88 |
83 |
$10K |
| E0118 |
Crutch substitute |
642 |
642 |
$10K |
| L4387 |
Non-pneum walk boot pre ots |
71 |
71 |
$9K |
| E0443 |
Portable 02 contents, gas |
167 |
167 |
$8K |
| A4425 |
Ost pch drain for barrier fl |
129 |
127 |
$8K |
| E0444 |
Portable 02 contents, liquid |
154 |
154 |
$8K |
| K0739 |
Repair/svc dme non-oxygen eq |
125 |
111 |
$7K |
| E1028 |
W/c manual swingaway |
66 |
40 |
$7K |
| A4623 |
Tracheostomy inner cannula |
37 |
30 |
$7K |
| B4088 |
Gastro/jejuno tube, low-pro |
172 |
166 |
$7K |
| E1372 |
Oxy suppl heater for nebuliz |
438 |
432 |
$6K |
| A4456 |
Adhesive remover, wipes |
455 |
447 |
$5K |
| A6402 |
Sterile gauze <= 16 sq in |
509 |
456 |
$5K |
| L3908 |
Who cock-up nonmolde pre ots |
104 |
75 |
$5K |
| A5120 |
Skin barrier, wipe or swab |
383 |
342 |
$4K |
| A7039 |
Filter, non disposable w pap |
463 |
458 |
$4K |
| A4216 |
Sterile water/saline, 10 ml |
158 |
147 |
$4K |
| K0003 |
Lightweight wheelchair |
65 |
65 |
$4K |
| A7037 |
Pos airway pressure tubing |
166 |
166 |
$4K |
| E0604 |
Hosp grade elec breast pump |
49 |
49 |
$3K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
94 |
94 |
$3K |
| E0971 |
Wheelchair anti-tipping devi |
143 |
113 |
$3K |
| E0114 |
Crutch underarm pair no wood |
47 |
47 |
$2K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
26 |
26 |
$2K |
| A4394 |
Ostomy pouch liq deodorant |
83 |
80 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
98 |
98 |
$2K |
| E0565 |
Compressor air power source |
50 |
50 |
$2K |
| A7003 |
Nebulizer administration set |
751 |
745 |
$2K |
| E0156 |
Walker seat attachment |
106 |
106 |
$2K |
| A4432 |
Os pch urine w bar/fange/tap |
27 |
25 |
$2K |
| A4358 |
Urinary leg or abdomen bag |
185 |
174 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
1,045 |
1,043 |
$1K |
| T4524 |
Adult size brief/diaper xl |
15 |
14 |
$1K |
| A7036 |
Pos airway press chinstrap |
107 |
106 |
$1K |
| B9002 |
Enter nutr inf pump any type |
26 |
25 |
$1K |
| A4406 |
Pectin based ostomy paste |
73 |
70 |
$1K |
| L3809 |
Whfo w/o joints pre ots |
18 |
15 |
$1K |
| A4483 |
Moisture exchanger |
28 |
18 |
$921.00 |
| A4618 |
Breathing circuits |
66 |
57 |
$859.92 |
| A4419 |
Ost pch for bar w flange/flt |
13 |
13 |
$829.35 |
| A4402 |
Lubricant per ounce |
142 |
139 |
$763.21 |
| A7521 |
Trach/laryn tube cuffed |
19 |
17 |
$761.19 |
| B4036 |
Enteral feed sup kit grav by |
29 |
28 |
$712.52 |
| E0181 |
Press pad alternating w/ pum |
63 |
63 |
$614.07 |
| A4338 |
Indwelling catheter latex |
42 |
39 |
$588.89 |
| E2601 |
Gen w/c cushion wdth < 22 in |
15 |
15 |
$552.40 |
| E0978 |
W/c acc,saf belt pelv strap |
27 |
27 |
$380.34 |
| A7014 |
Compressor nondispos filter |
218 |
218 |
$318.84 |
| A4371 |
Skin barrier powder per oz |
47 |
46 |
$234.27 |
| B9998 |
Enteral supp not otherwise c |
13 |
13 |
$193.67 |
| E0776 |
Iv pole |
40 |
40 |
$165.74 |
| A4332 |
Lube sterile packet |
12 |
12 |
$146.10 |
| A4452 |
Waterproof tape |
15 |
14 |
$105.02 |
| A6216 |
Non-sterile gauze<=16 sq in |
16 |
15 |
$71.99 |
| A7012 |
Nebulizer water collec devic |
16 |
15 |
$62.96 |
| A4367 |
Ostomy belt |
12 |
12 |
$56.42 |
| A4450 |
Non-waterproof tape |
41 |
41 |
$47.29 |
| A9900 |
Supply/accessory/service |
16 |
12 |
$0.00 |