| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
20,462 |
18,446 |
$1.99M |
| E0601 |
Cont airway pressure device |
15,382 |
14,595 |
$851K |
| A7030 |
Cpap full face mask |
5,179 |
4,904 |
$504K |
| E0570 |
Nebulizer with compression |
10,931 |
10,458 |
$368K |
| B4035 |
Enteral feed supp pump per d |
1,502 |
1,433 |
$340K |
| E0562 |
Humidifier heated used w pap |
17,017 |
16,087 |
$328K |
| E0470 |
Rad w/o backup non-inv intfc |
2,012 |
1,869 |
$248K |
| B4161 |
Ef ped hydrolyzed/amino acid |
363 |
339 |
$204K |
| A4604 |
Tubing with heating element |
5,785 |
5,511 |
$187K |
| L4361 |
Pneuma/vac walk boot pre ots |
1,709 |
1,650 |
$172K |
| T4541 |
Large disposable underpad |
3,299 |
3,080 |
$168K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,127 |
3,830 |
$166K |
| E1392 |
Portable oxygen concentrator |
6,849 |
5,968 |
$159K |
| A4670 |
Automatic bp monitor, dial |
2,543 |
2,483 |
$158K |
| E0143 |
Walker folding wheeled w/o s |
2,288 |
2,173 |
$153K |
| L3809 |
Whfo w/o joints pre ots |
1,506 |
1,477 |
$152K |
| K0001 |
Standard wheelchair |
5,647 |
5,173 |
$150K |
| T4528 |
Adult size pull-on xl |
974 |
935 |
$147K |
| B4152 |
Ef calorie dense>/=1.5kcal |
876 |
755 |
$145K |
| K0738 |
Portable gas oxygen system |
5,312 |
4,867 |
$139K |
| A7035 |
Pos airway press headgear |
5,816 |
5,530 |
$134K |
| T4526 |
Adult size pull-on med |
1,032 |
969 |
$126K |
| T4527 |
Adult size pull-on lg |
1,101 |
1,053 |
$125K |
| K0823 |
Pwc gp 2 std cap chair |
545 |
544 |
$119K |
| A7034 |
Nasal application device |
1,749 |
1,679 |
$97K |
| B9002 |
Enter nutr inf pump any type |
1,022 |
921 |
$88K |
| E0114 |
Crutch underarm pair no wood |
2,630 |
2,576 |
$84K |
| A6530 |
Compression stocking bk18-30 |
1,408 |
1,365 |
$79K |
| E0431 |
Portable gaseous 02 |
4,034 |
3,704 |
$77K |
| A7005 |
Nondisposable nebulizer set |
3,792 |
3,646 |
$73K |
| E1028 |
W/c manual swingaway |
1,859 |
1,663 |
$66K |
| L1902 |
Afo ankle gauntlet pre ots |
1,931 |
1,885 |
$66K |
| L3908 |
Who cock-up nonmolde pre ots |
2,365 |
2,271 |
$63K |
| L1820 |
Ko elas w/ condyle pads & jo |
545 |
514 |
$61K |
| T4535 |
Disposable liner/shield/pad |
1,312 |
1,245 |
$58K |
| K0006 |
Heavy duty wheelchair |
1,034 |
985 |
$55K |
| A6446 |
Conform band s w>=3" <5"/yd |
1,819 |
1,588 |
$54K |
| A7031 |
Replacement facemask interfa |
1,645 |
1,547 |
$51K |
| A4385 |
Ost skn barrier sld ext wear |
866 |
816 |
$50K |
| E0630 |
Patient lift hydraulic |
1,153 |
1,106 |
$49K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
497 |
470 |
$46K |
| A7526 |
Tracheostomy tube collar |
799 |
742 |
$45K |
| A4409 |
Ost skn barr convex <=4 sq i |
997 |
936 |
$43K |
| A7046 |
Repl water chamber, pap dev |
2,657 |
2,535 |
$33K |
| A7038 |
Pos airway pressure filter |
4,835 |
4,622 |
$31K |
| A4927 |
Non-sterile gloves |
2,282 |
2,130 |
$30K |
| L1812 |
Ko elastic w/joints pre ots |
959 |
893 |
$29K |
| E0445 |
Oximeter non-invasive |
522 |
471 |
$27K |
| A6402 |
Sterile gauze <= 16 sq in |
2,413 |
2,199 |
$25K |
| A4624 |
Tracheal suction tube |
162 |
152 |
$24K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
1,304 |
1,288 |
$20K |
| A4452 |
Waterproof tape |
887 |
796 |
$18K |
| A4357 |
Bedside drainage bag |
1,767 |
1,579 |
$18K |
| E0600 |
Suction pump portab hom modl |
705 |
644 |
$16K |
| L3650 |
So 8 abd restraint pre ots |
481 |
478 |
$16K |
| B4150 |
Ef complet w/intact nutrient |
137 |
127 |
$15K |
| E0471 |
Rad w/backup non inv intrfc |
53 |
49 |
$15K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
446 |
410 |
$14K |
| E0245 |
Tub stool or bench |
357 |
334 |
$13K |
| A4425 |
Ost pch drain for barrier fl |
289 |
269 |
$12K |
| E0156 |
Walker seat attachment |
938 |
895 |
$11K |
| A7000 |
Disposable canister for pump |
953 |
904 |
$11K |
| K0003 |
Lightweight wheelchair |
185 |
155 |
$10K |
| A7520 |
Trach/laryn tube non-cuffed |
133 |
115 |
$9K |
| B4088 |
Gastro/jejuno tube, low-pro |
74 |
68 |
$8K |
| L3670 |
So acro/clav can web pre ots |
335 |
324 |
$8K |
| A7507 |
Integrated filter & holder |
72 |
62 |
$8K |
| A4351 |
Straight tip urine catheter |
57 |
49 |
$8K |
| A4388 |
Drainable pch w ex wear barr |
227 |
215 |
$8K |
| E0776 |
Iv pole |
1,143 |
988 |
$7K |
| A4406 |
Pectin based ostomy paste |
447 |
420 |
$7K |
| A7003 |
Nebulizer administration set |
1,842 |
1,739 |
$6K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
74 |
64 |
$5K |
| A4358 |
Urinary leg or abdomen bag |
785 |
709 |
$5K |
| A7002 |
Tubing used w suction pump |
1,062 |
1,020 |
$5K |
| E0603 |
Electric breast pump |
41 |
41 |
$5K |
| A4649 |
Surgical supplies |
104 |
97 |
$5K |
| K0007 |
Extra heavy duty wheelchair |
73 |
73 |
$5K |
| A4450 |
Non-waterproof tape |
1,244 |
1,120 |
$4K |
| T4525 |
Adult size pull-on sm |
43 |
38 |
$4K |
| E0955 |
Cushioned headrest |
162 |
125 |
$3K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
30 |
28 |
$3K |
| A4362 |
Solid skin barrier |
76 |
66 |
$3K |
| E0303 |
Hosp bed hvy dty xtra wide |
37 |
37 |
$3K |
| A4407 |
Ext wear ost skn barr <=4sq" |
39 |
38 |
$3K |
| E0730 |
Tens four lead |
104 |
102 |
$3K |
| K0195 |
Elevating whlchair leg rests |
905 |
887 |
$3K |
| B4100 |
Food thickener oral |
15 |
12 |
$2K |
| T4522 |
Adult size brief/diaper med |
25 |
24 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
586 |
557 |
$2K |
| A7032 |
Replacement nasal cushion |
16 |
12 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
243 |
219 |
$2K |
| E0247 |
Trans bench w/wo comm open |
14 |
13 |
$1K |
| T4523 |
Adult size brief/diaper lg |
12 |
12 |
$1K |
| A6212 |
Foam drg <=16 sq in w/border |
17 |
16 |
$1K |
| K0739 |
Repair/svc dme non-oxygen eq |
68 |
54 |
$1K |
| A4432 |
Os pch urine w bar/fange/tap |
30 |
25 |
$1K |
| A5063 |
Drain ostomy pouch w/flange |
38 |
37 |
$1K |
| E0135 |
Walker folding adjust/fixed |
16 |
15 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
710 |
679 |
$921.69 |
| B4034 |
Enter feed supkit syr by day |
14 |
12 |
$812.85 |
| A4369 |
Skin barrier liquid per oz |
217 |
195 |
$587.05 |
| E0100 |
Cane adjust/fixed with tip |
24 |
24 |
$390.61 |
| A6266 |
Impreg gauze no h20/sal/yard |
14 |
12 |
$362.46 |
| E0443 |
Portable 02 contents, gas |
13 |
12 |
$354.06 |
| A4322 |
Irrigation syringe |
29 |
26 |
$347.81 |
| E0565 |
Compressor air power source |
13 |
12 |
$331.38 |
| A7037 |
Pos airway pressure tubing |
13 |
13 |
$262.60 |
| E0181 |
Press pad alternating w/ pum |
37 |
37 |
$254.78 |
| A4628 |
Oropharyngeal suction cath |
27 |
26 |
$65.27 |
| A4371 |
Skin barrier powder per oz |
14 |
12 |
$48.07 |