| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
62,417 |
61,296 |
$5.57M |
| E0431 |
Portable gaseous 02 |
46,426 |
44,664 |
$744K |
| E0601 |
Cont airway pressure device |
8,779 |
8,689 |
$476K |
| A7030 |
Cpap full face mask |
4,510 |
4,412 |
$422K |
| B4035 |
Enteral feed supp pump per d |
2,342 |
1,997 |
$415K |
| E0424 |
Stationary compressed gas 02 |
3,586 |
3,528 |
$397K |
| E0603 |
Electric breast pump |
2,112 |
2,086 |
$266K |
| T4541 |
Large disposable underpad |
2,409 |
2,329 |
$251K |
| E0470 |
Rad w/o backup non-inv intfc |
2,196 |
2,136 |
$238K |
| A7031 |
Replacement facemask interfa |
4,222 |
4,143 |
$226K |
| T4522 |
Adult size brief/diaper med |
1,642 |
1,606 |
$171K |
| T4527 |
Adult size pull-on lg |
1,115 |
1,104 |
$154K |
| E0562 |
Humidifier heated used w pap |
2,704 |
2,671 |
$144K |
| T4523 |
Adult size brief/diaper lg |
943 |
918 |
$129K |
| E0570 |
Nebulizer with compression |
5,345 |
5,258 |
$128K |
| E1392 |
Portable oxygen concentrator |
4,515 |
4,460 |
$127K |
| T4526 |
Adult size pull-on med |
1,045 |
1,034 |
$124K |
| A4604 |
Tubing with heating element |
3,118 |
3,074 |
$115K |
| K0001 |
Standard wheelchair |
5,399 |
5,282 |
$106K |
| B9998 |
Enteral supp not otherwise c |
732 |
601 |
$102K |
| E0445 |
Oximeter non-invasive |
717 |
702 |
$100K |
| A7034 |
Nasal application device |
1,592 |
1,564 |
$96K |
| K0003 |
Lightweight wheelchair |
2,415 |
2,356 |
$82K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
185 |
180 |
$73K |
| A7035 |
Pos airway press headgear |
3,944 |
3,827 |
$72K |
| E0471 |
Rad w/backup non inv intrfc |
281 |
276 |
$71K |
| A7038 |
Pos airway pressure filter |
8,341 |
8,183 |
$71K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,931 |
1,905 |
$69K |
| A4351 |
Straight tip urine catheter |
320 |
311 |
$52K |
| A7037 |
Pos airway pressure tubing |
2,819 |
2,776 |
$49K |
| E0143 |
Walker folding wheeled w/o s |
1,184 |
1,165 |
$47K |
| T4524 |
Adult size brief/diaper xl |
309 |
299 |
$45K |
| A7032 |
Replacement nasal cushion |
699 |
691 |
$44K |
| B9002 |
Enter nutr inf pump any type |
545 |
528 |
$43K |
| A4927 |
Non-sterile gloves |
3,396 |
3,191 |
$35K |
| A9901 |
Delivery/set up/dispensing |
6,403 |
5,779 |
$35K |
| A4452 |
Waterproof tape |
1,144 |
1,095 |
$32K |
| A7046 |
Repl water chamber, pap dev |
2,626 |
2,586 |
$30K |
| E0434 |
Portable liquid 02 |
1,426 |
1,372 |
$26K |
| E0202 |
Phototherapy light w/ photom |
510 |
118 |
$25K |
| A7033 |
Replacement nasal pillows |
412 |
410 |
$17K |
| T4528 |
Adult size pull-on xl |
116 |
116 |
$16K |
| A4425 |
Ost pch drain for barrier fl |
193 |
183 |
$13K |
| A4409 |
Ost skn barr convex <=4 sq i |
95 |
89 |
$12K |
| E0604 |
Hosp grade elec breast pump |
173 |
173 |
$11K |
| B4088 |
Gastro/jejuno tube, low-pro |
69 |
68 |
$11K |
| K0195 |
Elevating whlchair leg rests |
1,062 |
1,052 |
$10K |
| T4534 |
Youth size pull-on |
69 |
66 |
$9K |
| A6402 |
Sterile gauze <= 16 sq in |
1,005 |
897 |
$9K |
| A4385 |
Ost skn barrier sld ext wear |
106 |
102 |
$9K |
| B4150 |
Ef complet w/intact nutrient |
74 |
63 |
$8K |
| A6197 |
Alginate drsg >16 <=48 sq in |
14 |
14 |
$6K |
| A4322 |
Irrigation syringe |
244 |
208 |
$5K |
| E0600 |
Suction pump portab hom modl |
211 |
205 |
$5K |
| A6212 |
Foam drg <=16 sq in w/border |
14 |
12 |
$5K |
| E1399 |
Durable medical equipment mi |
32 |
27 |
$4K |
| T4530 |
Ped size brief/diaper lg |
50 |
49 |
$4K |
| A4554 |
Disposable underpads |
44 |
42 |
$2K |
| A7004 |
Disposable nebulizer sml vol |
1,311 |
1,286 |
$2K |
| A4406 |
Pectin based ostomy paste |
69 |
66 |
$1K |
| A6260 |
Wound cleanser any type/size |
103 |
98 |
$1K |
| A7000 |
Disposable canister for pump |
91 |
82 |
$1K |
| A7003 |
Nebulizer administration set |
409 |
400 |
$823.96 |
| A4335 |
Incontinence supply |
50 |
50 |
$705.85 |
| A5120 |
Skin barrier, wipe or swab |
66 |
63 |
$637.21 |
| A7015 |
Aerosol mask used w nebulize |
301 |
294 |
$433.33 |
| A4369 |
Skin barrier liquid per oz |
15 |
12 |
$281.06 |
| E0156 |
Walker seat attachment |
27 |
26 |
$248.59 |
| A6457 |
Tubular dressing |
15 |
12 |
$245.09 |
| A4520 |
Incontinence garment anytype |
14 |
12 |
$244.28 |
| E0776 |
Iv pole |
14 |
13 |
$242.31 |
| A9900 |
Supply/accessory/service |
17 |
13 |
$113.86 |
| A4371 |
Skin barrier powder per oz |
12 |
12 |
$36.63 |