| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
43,587 |
37,223 |
$3.03M |
| B4161 |
Ef ped hydrolyzed/amino acid |
2,624 |
1,796 |
$2.06M |
| E0601 |
Cont airway pressure device |
18,865 |
16,858 |
$961K |
| B4035 |
Enteral feed supp pump per d |
10,069 |
6,134 |
$840K |
| E0570 |
Nebulizer with compression |
16,052 |
14,221 |
$837K |
| E0466 |
Home vent non-invasive inter |
2,482 |
2,127 |
$779K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,793 |
4,515 |
$767K |
| E0465 |
Home vent invasive interface |
1,635 |
1,486 |
$702K |
| B9002 |
Enter nutr inf pump any type |
9,809 |
9,387 |
$600K |
| E0470 |
Rad w/o backup non-inv intfc |
4,112 |
3,777 |
$465K |
| E0445 |
Oximeter non-invasive |
5,697 |
5,464 |
$389K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,246 |
1,921 |
$372K |
| E1399 |
Durable medical equipment mi |
811 |
561 |
$361K |
| E0431 |
Portable gaseous 02 |
37,170 |
32,360 |
$333K |
| E0424 |
Stationary compressed gas 02 |
2,452 |
2,350 |
$309K |
| K0001 |
Standard wheelchair |
17,551 |
14,753 |
$302K |
| B4150 |
Ef complet w/intact nutrient |
1,528 |
1,386 |
$268K |
| A4209 |
5+ cc sterile syringe&needle |
2,334 |
2,161 |
$253K |
| B4149 |
Ef blenderized foods |
1,114 |
970 |
$232K |
| A4624 |
Tracheal suction tube |
2,079 |
1,808 |
$216K |
| E0143 |
Walker folding wheeled w/o s |
5,395 |
4,450 |
$191K |
| A4213 |
20+ cc syringe only |
3,593 |
3,339 |
$184K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,937 |
2,752 |
$174K |
| E0619 |
Apnea monitor w recorder |
1,778 |
1,362 |
$164K |
| T4534 |
Youth size pull-on |
1,538 |
1,468 |
$157K |
| A4627 |
Spacer bag/reservoir |
9,126 |
8,876 |
$143K |
| E0439 |
Stationary liquid 02 |
997 |
946 |
$132K |
| A4554 |
Disposable underpads |
3,136 |
2,850 |
$120K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,793 |
3,523 |
$120K |
| E0471 |
Rad w/backup non inv intrfc |
505 |
435 |
$100K |
| T4530 |
Ped size brief/diaper lg |
1,395 |
1,322 |
$88K |
| T4522 |
Adult size brief/diaper med |
947 |
896 |
$80K |
| E0562 |
Humidifier heated used w pap |
20,254 |
18,791 |
$76K |
| A4927 |
Non-sterile gloves |
4,789 |
4,220 |
$68K |
| E0255 |
Hospital bed var ht w/ mattr |
1,231 |
1,089 |
$68K |
| A4629 |
Tracheostomy care kit |
1,517 |
1,336 |
$66K |
| E1060 |
Wheelchair detachable arms |
1,048 |
1,006 |
$64K |
| E0600 |
Suction pump portab hom modl |
3,099 |
2,763 |
$63K |
| E0163 |
Commode chair with fixed arm |
2,282 |
1,901 |
$62K |
| T4521 |
Adult size brief/diaper sm |
867 |
794 |
$62K |
| A4351 |
Straight tip urine catheter |
488 |
413 |
$61K |
| K0007 |
Extra heavy duty wheelchair |
907 |
806 |
$61K |
| K0108 |
W/c component-accessory nos |
315 |
149 |
$58K |
| A7005 |
Nondisposable nebulizer set |
10,547 |
9,991 |
$56K |
| A7520 |
Trach/laryn tube non-cuffed |
1,309 |
1,178 |
$54K |
| E0630 |
Patient lift hydraulic |
2,841 |
2,090 |
$53K |
| A4216 |
Sterile water/saline, 10 ml |
1,162 |
1,035 |
$45K |
| E0565 |
Compressor air power source |
1,679 |
1,601 |
$43K |
| K0823 |
Pwc gp 2 std cap chair |
598 |
438 |
$42K |
| E1150 |
Wheelchair standard w/ leg r |
1,116 |
1,063 |
$42K |
| B9998 |
Enteral supp not otherwise c |
545 |
447 |
$42K |
| B4155 |
Ef incomplete/modular |
1,136 |
1,059 |
$40K |
| E1392 |
Portable oxygen concentrator |
3,632 |
3,171 |
$35K |
| A7508 |
Housing & integrated adhesiv |
616 |
568 |
$30K |
| A4322 |
Irrigation syringe |
1,158 |
988 |
$30K |
| A4452 |
Waterproof tape |
1,234 |
1,135 |
$28K |
| K0195 |
Elevating whlchair leg rests |
6,025 |
5,112 |
$26K |
| A4623 |
Tracheostomy inner cannula |
643 |
541 |
$26K |
| A7526 |
Tracheostomy tube collar |
2,602 |
2,313 |
$26K |
| A7003 |
Nebulizer administration set |
4,635 |
2,426 |
$25K |
| E0149 |
Heavy duty wheeled walker |
643 |
514 |
$25K |
| K0006 |
Heavy duty wheelchair |
604 |
500 |
$24K |
| E1028 |
W/c manual swingaway |
2,121 |
1,027 |
$24K |
| A6402 |
Sterile gauze <= 16 sq in |
2,714 |
2,437 |
$24K |
| A4244 |
Alcohol or peroxide per pint |
1,490 |
1,316 |
$23K |
| K0003 |
Lightweight wheelchair |
958 |
796 |
$22K |
| A4208 |
3 cc sterile syringe&needle |
100 |
95 |
$19K |
| A4353 |
Intermittent urinary cath |
50 |
48 |
$17K |
| A7030 |
Cpap full face mask |
2,463 |
1,821 |
$17K |
| E0776 |
Iv pole |
2,722 |
2,576 |
$17K |
| B4034 |
Enter feed supkit syr by day |
436 |
251 |
$17K |
| A7031 |
Replacement facemask interfa |
3,181 |
2,379 |
$14K |
| A7002 |
Tubing used w suction pump |
3,083 |
2,778 |
$13K |
| B4036 |
Enteral feed sup kit grav by |
157 |
114 |
$12K |
| A7000 |
Disposable canister for pump |
2,287 |
2,006 |
$11K |
| T4525 |
Adult size pull-on sm |
110 |
105 |
$10K |
| A4402 |
Lubricant per ounce |
392 |
327 |
$7K |
| A7015 |
Aerosol mask used w nebulize |
14,417 |
13,817 |
$6K |
| A6216 |
Non-sterile gauze<=16 sq in |
650 |
566 |
$5K |
| A7033 |
Replacement nasal pillows |
963 |
783 |
$5K |
| E1226 |
Manual fully reclining back |
84 |
69 |
$5K |
| E0971 |
Wheelchair anti-tipping devi |
646 |
392 |
$5K |
| A7034 |
Nasal application device |
1,491 |
1,160 |
$4K |
| A7032 |
Replacement nasal cushion |
1,085 |
862 |
$4K |
| K0739 |
Repair/svc dme non-oxygen eq |
993 |
497 |
$4K |
| E0156 |
Walker seat attachment |
1,759 |
1,402 |
$4K |
| T4523 |
Adult size brief/diaper lg |
50 |
38 |
$4K |
| A7038 |
Pos airway pressure filter |
5,961 |
4,499 |
$4K |
| E0973 |
W/ch access det adj armrest |
247 |
159 |
$3K |
| A7037 |
Pos airway pressure tubing |
654 |
564 |
$3K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
85 |
80 |
$3K |
| A7525 |
Tracheostomy mask |
1,518 |
881 |
$3K |
| A4604 |
Tubing with heating element |
3,132 |
2,267 |
$3K |
| A7007 |
Lg vol nebulizer disposable |
372 |
245 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
209 |
169 |
$2K |
| A4450 |
Non-waterproof tape |
123 |
102 |
$2K |
| T4533 |
Youth size brief/diaper |
40 |
40 |
$2K |
| A7035 |
Pos airway press headgear |
1,946 |
1,496 |
$2K |
| E0434 |
Portable liquid 02 |
157 |
153 |
$2K |
| E0978 |
W/c acc,saf belt pelv strap |
279 |
224 |
$2K |
| E0185 |
Gel pressure mattress pad |
216 |
148 |
$2K |
| A4245 |
Alcohol wipes per box |
366 |
347 |
$2K |
| E0245 |
Tub stool or bench |
66 |
60 |
$2K |
| A7046 |
Repl water chamber, pap dev |
1,437 |
1,156 |
$1K |
| E0961 |
Wheelchair brake extension |
457 |
279 |
$1K |
| A7012 |
Nebulizer water collec devic |
274 |
240 |
$1K |
| A4253 |
Blood glucose/reagent strips |
25 |
24 |
$1K |
| E0181 |
Press pad alternating w/ pum |
139 |
104 |
$730.75 |
| K0738 |
Portable gas oxygen system |
996 |
711 |
$687.62 |
| E2611 |
Gen use back cush wdth <22in |
18 |
15 |
$668.06 |
| A4605 |
Trach suction cath close sys |
34 |
28 |
$409.21 |
| A4357 |
Bedside drainage bag |
174 |
115 |
$395.31 |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
16 |
13 |
$248.50 |
| A7010 |
Disposable corrugated tubing |
32 |
26 |
$195.38 |
| A4628 |
Oropharyngeal suction cath |
67 |
50 |
$191.08 |
| A4616 |
Tubing (oxygen) per foot |
109 |
97 |
$18.70 |
| E0955 |
Cushioned headrest |
16 |
12 |
$12.13 |
| A7039 |
Filter, non disposable w pap |
13 |
12 |
$7.28 |
| A7036 |
Pos airway press chinstrap |
16 |
14 |
$2.34 |
| A4657 |
Syringe w/wo needle |
63 |
53 |
$1.83 |