| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
257,497 |
254,405 |
$13.83M |
| A4554 |
Disposable underpads |
439,344 |
433,928 |
$11.88M |
| T4523 |
Adult size brief/diaper lg |
180,929 |
178,571 |
$8.61M |
| E0466 |
Home vent non-invasive inter |
13,397 |
13,263 |
$6.71M |
| T4522 |
Adult size brief/diaper med |
167,909 |
165,935 |
$5.60M |
| E0603 |
Electric breast pump |
33,071 |
32,726 |
$5.18M |
| T4524 |
Adult size brief/diaper xl |
90,394 |
89,230 |
$5.06M |
| E0601 |
Cont airway pressure device |
110,563 |
109,660 |
$4.97M |
| T4535 |
Disposable liner/shield/pad |
324,182 |
319,365 |
$4.75M |
| E0143 |
Walker folding wheeled w/o s |
105,971 |
104,020 |
$3.37M |
| A7030 |
Cpap full face mask |
43,878 |
43,644 |
$2.57M |
| T4543 |
Adult disp brief/diap abv xl |
24,773 |
24,381 |
$2.56M |
| K0001 |
Standard wheelchair |
248,761 |
245,846 |
$2.50M |
| E0260 |
Hosp bed semi-electr w/ matt |
137,194 |
136,031 |
$2.22M |
| T4537 |
Reusable underpad bed size |
121,981 |
120,674 |
$2.19M |
| T4533 |
Youth size brief/diaper |
27,793 |
27,549 |
$2.12M |
| E0431 |
Portable gaseous 02 |
170,968 |
169,175 |
$2.08M |
| E0562 |
Humidifier heated used w pap |
25,587 |
25,360 |
$1.99M |
| A7031 |
Replacement facemask interfa |
48,336 |
47,907 |
$1.97M |
| E0261 |
Hosp bed semi-electr w/o mat |
47,856 |
47,399 |
$1.63M |
| E0465 |
Home vent invasive interface |
3,082 |
2,933 |
$1.63M |
| A7032 |
Replacement nasal cushion |
38,016 |
37,657 |
$1.62M |
| E0277 |
Powered pres-redu air mattrs |
11,778 |
11,702 |
$1.57M |
| E0240 |
Bath/shower chair |
50,666 |
50,112 |
$1.56M |
| E0630 |
Patient lift hydraulic |
59,031 |
58,470 |
$1.55M |
| E0247 |
Trans bench w/wo comm open |
19,174 |
18,877 |
$1.39M |
| T4521 |
Adult size brief/diaper sm |
27,790 |
27,449 |
$1.34M |
| E2611 |
Gen use back cush wdth <22in |
20,693 |
20,104 |
$1.33M |
| E0163 |
Commode chair with fixed arm |
42,986 |
42,075 |
$1.32M |
| K0003 |
Lightweight wheelchair |
70,485 |
69,731 |
$1.27M |
| E0784 |
Ext amb infusn pump insulin |
949 |
935 |
$1.22M |
| E0470 |
Rad w/o backup non-inv intfc |
14,769 |
14,651 |
$1.20M |
| A7034 |
Nasal application device |
52,815 |
52,528 |
$1.16M |
| E1392 |
Portable oxygen concentrator |
44,657 |
44,310 |
$1.13M |
| A4230 |
Infus insulin pump non needl |
4,038 |
3,815 |
$898K |
| E0483 |
Hi freq chest wall oscil sys |
1,444 |
1,435 |
$765K |
| A4624 |
Tracheal suction tube |
6,301 |
6,064 |
$751K |
| E0570 |
Nebulizer with compression |
69,020 |
68,240 |
$732K |
| E0241 |
Bath tub wall rail |
24,890 |
24,170 |
$719K |
| A4927 |
Non-sterile gloves |
206,775 |
203,956 |
$717K |
| B4035 |
Enteral feed supp pump per d |
6,177 |
5,952 |
$716K |
| A7035 |
Pos airway press headgear |
62,258 |
61,926 |
$667K |
| E0185 |
Gel pressure mattress pad |
12,753 |
12,391 |
$662K |
| E0971 |
Wheelchair anti-tipping devi |
37,778 |
27,988 |
$625K |
| E0990 |
Wheelchair elevating leg res |
68,945 |
67,868 |
$602K |
| A7033 |
Replacement nasal pillows |
17,466 |
17,307 |
$569K |
| B4154 |
Ef spec metabolic noninherit |
5,093 |
4,938 |
$551K |
| A4670 |
Automatic bp monitor, dial |
13,625 |
13,487 |
$548K |
| E0445 |
Oximeter non-invasive |
5,244 |
5,146 |
$506K |
| B4150 |
Ef complet w/intact nutrient |
7,062 |
6,820 |
$499K |
| A7037 |
Pos airway pressure tubing |
52,272 |
52,042 |
$493K |
| B4152 |
Ef calorie dense>/=1.5kcal |
6,102 |
5,849 |
$490K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
4,783 |
4,609 |
$480K |
| A7038 |
Pos airway pressure filter |
121,397 |
120,025 |
$479K |
| K0823 |
Pwc gp 2 std cap chair |
3,546 |
3,529 |
$450K |
| K0739 |
Repair/svc dme non-oxygen eq |
7,483 |
7,319 |
$428K |
| E2601 |
Gen w/c cushion wdth < 22 in |
28,897 |
28,021 |
$422K |
| A4629 |
Tracheostomy care kit |
6,173 |
6,022 |
$420K |
| T4539 |
Reuse diaper/brief any size |
26,270 |
25,730 |
$411K |
| A4351 |
Straight tip urine catheter |
3,649 |
3,580 |
$408K |
| E1226 |
Manual fully reclining back |
3,702 |
3,572 |
$387K |
| E0156 |
Walker seat attachment |
50,027 |
49,303 |
$385K |
| K0006 |
Heavy duty wheelchair |
12,111 |
11,898 |
$355K |
| A4604 |
Tubing with heating element |
39,709 |
39,518 |
$350K |
| T4540 |
Reusable underpad chair size |
28,380 |
28,053 |
$349K |
| E0274 |
Over-bed table |
5,068 |
4,958 |
$339K |
| E0244 |
Toilet seat raised |
19,768 |
19,432 |
$328K |
| E0600 |
Suction pump portab hom modl |
12,810 |
12,656 |
$313K |
| E0271 |
Mattress innerspring |
8,083 |
7,911 |
$307K |
| E1399 |
Durable medical equipment mi |
7,793 |
7,604 |
$300K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,580 |
1,414 |
$291K |
| E0973 |
W/ch access det adj armrest |
10,492 |
7,516 |
$285K |
| E0149 |
Heavy duty wheeled walker |
13,639 |
13,397 |
$279K |
| K0553 |
Ther cgm supply allowance |
1,290 |
1,281 |
$270K |
| A4239 |
Non-adju cgm supply allow |
2,671 |
2,609 |
$267K |
| K0195 |
Elevating whlchair leg rests |
94,834 |
93,978 |
$252K |
| K0800 |
Pov group 1 std up to 300lbs |
6,365 |
6,353 |
$249K |
| K0007 |
Extra heavy duty wheelchair |
4,962 |
4,914 |
$246K |
| K0004 |
High strength ltwt whlchr |
4,394 |
4,328 |
$221K |
| E0482 |
Cough stimulating device |
862 |
856 |
$208K |
| E0961 |
Wheelchair brake extension |
24,222 |
17,547 |
$205K |
| A4623 |
Tracheostomy inner cannula |
3,401 |
3,298 |
$188K |
| E0471 |
Rad w/backup non inv intrfc |
1,578 |
1,567 |
$187K |
| E0303 |
Hosp bed hvy dty xtra wide |
3,861 |
3,845 |
$181K |
| B4034 |
Enter feed supkit syr by day |
4,053 |
3,863 |
$171K |
| A4232 |
Syringe w/needle insulin 3cc |
3,689 |
3,442 |
$171K |
| K0738 |
Portable gas oxygen system |
17,761 |
17,601 |
$168K |
| A6197 |
Alginate drsg >16 <=48 sq in |
1,300 |
1,246 |
$162K |
| A6212 |
Foam drg <=16 sq in w/border |
1,887 |
1,801 |
$157K |
| A4353 |
Intermittent urinary cath |
514 |
500 |
$150K |
| E0100 |
Cane adjust/fixed with tip |
16,345 |
16,181 |
$146K |
| A4217 |
Sterile water/saline, 500 ml |
10,883 |
10,431 |
$145K |
| K0801 |
Pov group 1 hd 301-450 lbs |
1,647 |
1,645 |
$140K |
| E0301 |
Hd hosp bed, 350-600 lbs |
1,102 |
1,077 |
$133K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
1,107 |
1,056 |
$130K |
| A7046 |
Repl water chamber, pap dev |
29,087 |
28,947 |
$130K |
| E0978 |
W/c acc,saf belt pelv strap |
15,403 |
14,990 |
$128K |
| E0565 |
Compressor air power source |
4,914 |
4,859 |
$118K |
| K0825 |
Pwc gp 2 hd cap chair |
523 |
522 |
$113K |
| E0165 |
Commode chair with detacharm |
7,988 |
7,850 |
$110K |
| E1038 |
Transport chair pt wt<=300lb |
39,854 |
39,531 |
$108K |
| E0181 |
Press pad alternating w/ pum |
19,669 |
19,465 |
$107K |
| A6402 |
Sterile gauze <= 16 sq in |
10,989 |
10,514 |
$104K |
| B9002 |
Enter nutr inf pump any type |
2,243 |
2,199 |
$102K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
1,846 |
1,800 |
$96K |
| E0168 |
Heavyduty/wide commode chair |
2,613 |
2,573 |
$94K |
| A7520 |
Trach/laryn tube non-cuffed |
2,781 |
2,685 |
$93K |
| E0105 |
Cane adjust/fixed quad/3 pro |
5,610 |
5,553 |
$93K |
| A4253 |
Blood glucose/reagent strips |
6,047 |
5,959 |
$91K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
832 |
815 |
$83K |
| E0243 |
Toilet rail |
2,511 |
2,487 |
$82K |
| A7526 |
Tracheostomy tube collar |
4,776 |
4,622 |
$78K |
| A4216 |
Sterile water/saline, 10 ml |
3,977 |
3,817 |
$76K |
| E0246 |
Transfer tub rail attachment |
2,049 |
2,021 |
$74K |
| A9276 |
Disposable sensor, cgm sys |
291 |
288 |
$74K |
| A4349 |
Disposable male external cat |
2,826 |
2,749 |
$74K |
| E2612 |
Gen use back cush wdth>=22in |
719 |
695 |
$73K |
| A7005 |
Nondisposable nebulizer set |
9,216 |
9,135 |
$69K |
| A7000 |
Disposable canister for pump |
8,111 |
7,878 |
$69K |
| A4409 |
Ost skn barr convex <=4 sq i |
1,559 |
1,538 |
$68K |
| K0002 |
Stnd hemi (low seat) whlchr |
4,210 |
4,151 |
$66K |
| A5063 |
Drain ostomy pouch w/flange |
1,648 |
1,624 |
$65K |
| E0265 |
Hosp bed total electr w/ mat |
1,699 |
1,675 |
$65K |
| A4402 |
Lubricant per ounce |
13,025 |
12,782 |
$64K |
| A4605 |
Trach suction cath close sys |
724 |
701 |
$62K |
| E0248 |
Hdtrans bench w/wo comm open |
484 |
475 |
$61K |
| E0245 |
Tub stool or bench |
2,598 |
2,574 |
$60K |
| E2622 |
Adj skin pro w/c cus wd<22in |
662 |
643 |
$60K |
| A4357 |
Bedside drainage bag |
4,260 |
4,157 |
$60K |
| E2202 |
Seat width 24-27 in |
712 |
701 |
$58K |
| A4358 |
Urinary leg or abdomen bag |
3,910 |
3,813 |
$57K |
| E0114 |
Crutch underarm pair no wood |
2,227 |
2,209 |
$56K |
| A7039 |
Filter, non disposable w pap |
21,384 |
21,301 |
$55K |
| E1020 |
Residual limb support system |
3,323 |
3,118 |
$52K |
| A7521 |
Trach/laryn tube cuffed |
1,499 |
1,463 |
$48K |
| A4385 |
Ost skn barrier sld ext wear |
1,152 |
1,117 |
$48K |
| A4425 |
Ost pch drain for barrier fl |
1,081 |
1,061 |
$46K |
| E2602 |
Gen w/c cushion wdth >=22 in |
1,251 |
1,219 |
$44K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
1,015 |
996 |
$42K |
| A6446 |
Conform band s w>=3" <5"/yd |
2,888 |
2,814 |
$38K |
| A6240 |
Hydrocolld drg filler paste |
1,007 |
992 |
$38K |
| A4628 |
Oropharyngeal suction cath |
5,623 |
5,440 |
$37K |
| E0310 |
Rails bed side full length |
2,302 |
2,268 |
$36K |
| E0135 |
Walker folding adjust/fixed |
1,648 |
1,618 |
$35K |
| E0951 |
Loop heel |
3,237 |
2,503 |
$29K |
| A4407 |
Ext wear ost skn barr <=4sq" |
434 |
422 |
$28K |
| E0910 |
Trapeze bar attached to bed |
5,898 |
5,803 |
$28K |
| A7036 |
Pos airway press chinstrap |
4,597 |
4,585 |
$27K |
| A4362 |
Solid skin barrier |
641 |
625 |
$27K |
| A4452 |
Waterproof tape |
2,694 |
2,633 |
$26K |
| A4335 |
Incontinence supply |
4,265 |
4,217 |
$26K |
| E0635 |
Patient lift electric |
1,143 |
1,141 |
$25K |
| E0266 |
Hosp bed total elec w/o matt |
336 |
330 |
$25K |
| B4088 |
Gastro/jejuno tube, low-pro |
341 |
335 |
$23K |
| A7002 |
Tubing used w suction pump |
7,752 |
7,502 |
$23K |
| E2603 |
Skin protect wc cus wd <22in |
644 |
614 |
$21K |
| E2103 |
Non-adju cgm receiver/mon |
157 |
157 |
$21K |
| A4322 |
Irrigation syringe |
1,448 |
1,331 |
$21K |
| E1028 |
W/c manual swingaway |
2,905 |
2,688 |
$20K |
| T4530 |
Ped size brief/diaper lg |
281 |
279 |
$20K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
522 |
510 |
$19K |
| E0443 |
Portable 02 contents, gas |
2,754 |
2,732 |
$19K |
| A5120 |
Skin barrier, wipe or swab |
2,689 |
2,620 |
$17K |
| A6250 |
Skin seal protect moisturizr |
790 |
769 |
$17K |
| E2365 |
U1 sealed leadacid battery |
357 |
356 |
$17K |
| E0705 |
Transfer device |
973 |
948 |
$17K |
| A4259 |
Lancets per box |
5,473 |
5,393 |
$16K |
| A6196 |
Alginate dressing <=16 sq in |
193 |
189 |
$16K |
| E1031 |
Rollabout chair with casters |
1,995 |
1,986 |
$15K |
| V5266 |
Battery for hearing device |
1,419 |
1,408 |
$15K |
| A6449 |
Lt compres band >=3" <5"/yd |
549 |
528 |
$15K |
| E0776 |
Iv pole |
2,573 |
2,558 |
$13K |
| A4450 |
Non-waterproof tape |
3,508 |
3,431 |
$12K |
| A6248 |
Hydrogel drsg gel filler |
286 |
280 |
$12K |
| A7007 |
Lg vol nebulizer disposable |
3,465 |
3,378 |
$11K |
| K0053 |
Elevate footrest articulate |
1,878 |
1,811 |
$11K |
| A4417 |
Ost pch w bar/bltinconv/fltr |
130 |
128 |
$11K |
| E0912 |
Hd trapeze bar free standing |
405 |
404 |
$11K |
| T4534 |
Youth size pull-on |
137 |
135 |
$11K |
| A6403 |
Sterile gauze>16 <= 48 sq in |
397 |
390 |
$8K |
| B4153 |
Ef hydrolyzed/amino acids |
15 |
12 |
$8K |
| A4287 |
Disp col sto bag breast milk |
182 |
182 |
$8K |
| A4456 |
Adhesive remover, wipes |
1,009 |
992 |
$8K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
31 |
28 |
$7K |
| K0554 |
Ther cgm receiver/monitor |
30 |
30 |
$7K |
| A6454 |
Self-adher band w>=3" <5"/yd |
521 |
508 |
$7K |
| A4310 |
Insert tray w/o bag/cath |
889 |
850 |
$7K |
| A6258 |
Transparent film >16<=48 in |
240 |
226 |
$7K |
| A7525 |
Tracheostomy mask |
3,169 |
3,085 |
$7K |
| E0190 |
Positioning cushion |
406 |
396 |
$7K |
| E0110 |
Crutch forearm pair |
140 |
140 |
$7K |
| A4245 |
Alcohol wipes per box |
5,874 |
5,766 |
$6K |
| A9277 |
External transmitter, cgm |
18 |
18 |
$6K |
| A7010 |
Disposable corrugated tubing |
1,206 |
1,164 |
$6K |
| E0215 |
Electric heat pad moist |
201 |
201 |
$6K |
| A7003 |
Nebulizer administration set |
2,409 |
2,319 |
$6K |
| K0052 |
Swingaway detach ftrest repl |
1,297 |
1,276 |
$5K |
| A6456 |
Zinc paste band w >=3"<5"/yd |
328 |
316 |
$5K |
| E0154 |
Walker platform attachment |
196 |
168 |
$5K |
| A6216 |
Non-sterile gauze<=16 sq in |
1,087 |
1,047 |
$5K |
| B4100 |
Food thickener oral |
116 |
116 |
$5K |
| A4231 |
Infusion insulin pump needle |
49 |
42 |
$4K |
| A4432 |
Os pch urine w bar/fange/tap |
162 |
158 |
$4K |
| E1039 |
Transport chair pt wt >300lb |
591 |
590 |
$4K |
| A7015 |
Aerosol mask used w nebulize |
4,585 |
4,533 |
$3K |
| A4520 |
Incontinence garment anytype |
33 |
33 |
$3K |
| A4406 |
Pectin based ostomy paste |
268 |
264 |
$3K |
| E2209 |
Arm trough each |
81 |
78 |
$3K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
37 |
36 |
$3K |
| E0210 |
Electric heat pad standard |
225 |
225 |
$3K |
| A4371 |
Skin barrier powder per oz |
807 |
792 |
$3K |
| A4394 |
Ostomy pouch liq deodorant |
351 |
345 |
$2K |
| E2208 |
Cylinder tank carrier |
163 |
154 |
$2K |
| A6450 |
Lt compres band >=5"/yd |
188 |
183 |
$2K |
| A6219 |
Gauze <= 16 sq in w/border |
168 |
157 |
$2K |
| A7012 |
Nebulizer water collec devic |
882 |
868 |
$2K |
| E0607 |
Blood glucose monitor home |
59 |
58 |
$2K |
| B4036 |
Enteral feed sup kit grav by |
25 |
24 |
$2K |
| A4338 |
Indwelling catheter latex |
899 |
877 |
$2K |
| A6207 |
Contact layer >16<= 48 sq in |
41 |
41 |
$2K |
| A4225 |
Sup/ext insulin inf pump syr |
672 |
672 |
$2K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
65 |
64 |
$2K |
| E0950 |
Tray |
81 |
79 |
$2K |
| E2361 |
22nf sealed leadacid battery |
15 |
15 |
$1K |
| A4224 |
Supply insulin inf cath/wk |
77 |
77 |
$1K |
| A4244 |
Alcohol or peroxide per pint |
718 |
707 |
$1K |
| E0325 |
Urinal male jug-type |
449 |
446 |
$1K |
| K0056 |
Seat ht <17 or >=21 ltwt wc |
69 |
69 |
$1K |
| E0118 |
Crutch substitute |
36 |
36 |
$1K |
| E0305 |
Rails bed side half length |
59 |
58 |
$1K |
| A4367 |
Ostomy belt |
255 |
254 |
$1K |
| A6443 |
Conform band n/s w>=3"<5"/yd |
207 |
196 |
$973.46 |
| A4246 |
Betadine/phisohex solution |
221 |
217 |
$866.60 |
| A4320 |
Irrigation tray |
48 |
47 |
$472.73 |
| A4660 |
Sphyg/bp app w cuff and stet |
27 |
27 |
$398.57 |
| L0625 |
Lo flex l1-below l5 pre ots |
12 |
12 |
$375.35 |
| A4419 |
Ost pch for bar w flange/flt |
12 |
12 |
$371.51 |
| A4618 |
Breathing circuits |
133 |
124 |
$368.11 |
| A4258 |
Lancet device each |
72 |
71 |
$359.50 |
| A6199 |
Alginate drsg wound filler |
13 |
13 |
$350.33 |
| L3908 |
Who cock-up nonmolde pre ots |
12 |
12 |
$330.94 |
| T4541 |
Large disposable underpad |
12 |
12 |
$321.36 |
| A4455 |
Adhesive remover per ounce |
33 |
30 |
$282.11 |
| A4333 |
Urinary cath anchor device |
55 |
51 |
$227.32 |
| A6530 |
Compression stocking bk18-30 |
15 |
14 |
$181.14 |
| A6266 |
Impreg gauze no h20/sal/yard |
12 |
12 |
$171.28 |
| A4344 |
Cath indw foley 2 way silicn |
13 |
13 |
$150.33 |
| A6457 |
Tubular dressing |
14 |
14 |
$148.73 |
| A6445 |
Conform band s w <3"/yd |
32 |
30 |
$143.99 |
| E0960 |
W/c shoulder harness/straps |
13 |
13 |
$120.43 |
| A7006 |
Filtered nebulizer admin set |
25 |
24 |
$111.54 |
| A7013 |
Disposable compressor filter |
135 |
133 |
$16.47 |
| A4615 |
Cannula nasal |
15 |
15 |
$8.10 |
| K0733 |
12-24hr sealed lead acid |
29 |
29 |
$5.30 |