| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
20,131 |
19,918 |
$1.47M |
| E0465 |
Home vent invasive interface |
1,206 |
1,121 |
$733K |
| B4150 |
Ef complet w/intact nutrient |
6,838 |
6,614 |
$728K |
| B4035 |
Enteral feed supp pump per d |
2,768 |
2,553 |
$496K |
| E0601 |
Cont airway pressure device |
9,456 |
9,309 |
$427K |
| E0445 |
Oximeter non-invasive |
1,639 |
1,595 |
$381K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,280 |
2,074 |
$351K |
| S8189 |
Trach supply noc |
1,484 |
1,410 |
$317K |
| A4624 |
Tracheal suction tube |
2,439 |
2,251 |
$278K |
| E0431 |
Portable gaseous 02 |
13,580 |
13,406 |
$235K |
| E0470 |
Rad w/o backup non-inv intfc |
2,503 |
2,483 |
$210K |
| B4087 |
Gastro/jejuno tube, std |
3,417 |
3,086 |
$202K |
| E0466 |
Home vent non-invasive inter |
319 |
313 |
$176K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,694 |
1,610 |
$173K |
| A7526 |
Tracheostomy tube collar |
2,993 |
2,872 |
$162K |
| E0570 |
Nebulizer with compression |
3,999 |
3,975 |
$154K |
| A4629 |
Tracheostomy care kit |
1,968 |
1,909 |
$127K |
| A7030 |
Cpap full face mask |
2,343 |
2,291 |
$120K |
| A7520 |
Trach/laryn tube non-cuffed |
1,777 |
1,680 |
$110K |
| E0562 |
Humidifier heated used w pap |
1,696 |
1,659 |
$106K |
| B9002 |
Enter nutr inf pump any type |
1,667 |
1,621 |
$100K |
| E0143 |
Walker folding wheeled w/o s |
1,717 |
1,676 |
$75K |
| A7034 |
Nasal application device |
2,215 |
2,169 |
$74K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,691 |
1,669 |
$74K |
| A4606 |
Oxygen probe used w oximeter |
774 |
681 |
$67K |
| E0603 |
Electric breast pump |
542 |
540 |
$66K |
| B4100 |
Food thickener oral |
619 |
595 |
$56K |
| A7035 |
Pos airway press headgear |
3,531 |
3,469 |
$51K |
| K0001 |
Standard wheelchair |
2,028 |
1,970 |
$50K |
| A7037 |
Pos airway pressure tubing |
2,914 |
2,878 |
$48K |
| A4927 |
Non-sterile gloves |
2,387 |
2,195 |
$48K |
| B4036 |
Enteral feed sup kit grav by |
331 |
318 |
$45K |
| A7031 |
Replacement facemask interfa |
1,821 |
1,770 |
$44K |
| K0003 |
Lightweight wheelchair |
1,014 |
1,009 |
$40K |
| E0600 |
Suction pump portab hom modl |
1,084 |
1,065 |
$34K |
| A7005 |
Nondisposable nebulizer set |
2,482 |
2,458 |
$32K |
| B4034 |
Enter feed supkit syr by day |
792 |
740 |
$32K |
| B4152 |
Ef calorie dense>/=1.5kcal |
208 |
200 |
$26K |
| A4628 |
Oropharyngeal suction cath |
1,431 |
1,334 |
$24K |
| A7032 |
Replacement nasal cushion |
879 |
854 |
$24K |
| A6530 |
Compression stocking bk18-30 |
434 |
397 |
$22K |
| A7038 |
Pos airway pressure filter |
5,115 |
4,959 |
$20K |
| E0135 |
Walker folding adjust/fixed |
418 |
409 |
$18K |
| E1399 |
Durable medical equipment mi |
202 |
138 |
$16K |
| B4161 |
Ef ped hydrolyzed/amino acid |
49 |
39 |
$15K |
| K0738 |
Portable gas oxygen system |
2,320 |
2,318 |
$15K |
| L8501 |
Tracheostomy speaking valve |
183 |
180 |
$14K |
| A7000 |
Disposable canister for pump |
2,271 |
2,182 |
$13K |
| A7002 |
Tubing used w suction pump |
1,989 |
1,912 |
$13K |
| E0156 |
Walker seat attachment |
1,478 |
1,446 |
$12K |
| A7046 |
Repl water chamber, pap dev |
2,162 |
2,118 |
$12K |
| B9998 |
Enteral supp not otherwise c |
170 |
157 |
$10K |
| E0776 |
Iv pole |
1,196 |
1,176 |
$9K |
| S5199 |
Personal care item nos each |
842 |
786 |
$9K |
| A4452 |
Waterproof tape |
442 |
412 |
$8K |
| A6402 |
Sterile gauze <= 16 sq in |
1,464 |
1,317 |
$8K |
| A4649 |
Surgical supplies |
298 |
199 |
$7K |
| T4535 |
Disposable liner/shield/pad |
210 |
189 |
$7K |
| A4351 |
Straight tip urine catheter |
86 |
79 |
$6K |
| A4670 |
Automatic bp monitor, dial |
122 |
120 |
$6K |
| E0424 |
Stationary compressed gas 02 |
36 |
36 |
$5K |
| A4604 |
Tubing with heating element |
996 |
971 |
$5K |
| E0971 |
Wheelchair anti-tipping devi |
1,420 |
884 |
$5K |
| A4623 |
Tracheostomy inner cannula |
56 |
51 |
$4K |
| T4541 |
Large disposable underpad |
168 |
147 |
$4K |
| A4213 |
20+ cc syringe only |
807 |
729 |
$4K |
| E0619 |
Apnea monitor w recorder |
24 |
24 |
$3K |
| K0002 |
Stnd hemi (low seat) whlchr |
101 |
101 |
$3K |
| A7507 |
Integrated filter & holder |
66 |
64 |
$3K |
| E1392 |
Portable oxygen concentrator |
612 |
611 |
$3K |
| T4530 |
Ped size brief/diaper lg |
54 |
42 |
$3K |
| T4525 |
Adult size pull-on sm |
31 |
25 |
$3K |
| E0155 |
Walker wheel attachment,pair |
202 |
200 |
$3K |
| A7003 |
Nebulizer administration set |
1,396 |
1,347 |
$3K |
| A6446 |
Conform band s w>=3" <5"/yd |
247 |
217 |
$3K |
| A7033 |
Replacement nasal pillows |
105 |
104 |
$3K |
| E0443 |
Portable 02 contents, gas |
224 |
121 |
$3K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
56 |
45 |
$2K |
| A7012 |
Nebulizer water collec devic |
453 |
442 |
$2K |
| A4450 |
Non-waterproof tape |
387 |
339 |
$2K |
| K0195 |
Elevating whlchair leg rests |
187 |
158 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,066 |
1,003 |
$1K |
| T2029 |
Special med equip, noswaiver |
12 |
12 |
$1K |
| A6216 |
Non-sterile gauze<=16 sq in |
139 |
133 |
$1K |
| A4357 |
Bedside drainage bag |
91 |
81 |
$485.47 |
| A7525 |
Tracheostomy mask |
136 |
125 |
$448.71 |
| A4338 |
Indwelling catheter latex |
69 |
63 |
$219.31 |
| A7007 |
Lg vol nebulizer disposable |
30 |
26 |
$191.92 |
| A4358 |
Urinary leg or abdomen bag |
15 |
15 |
$156.61 |
| A4402 |
Lubricant per ounce |
114 |
105 |
$135.93 |
| A4310 |
Insert tray w/o bag/cath |
43 |
40 |
$103.19 |
| A4331 |
Extension drainage tubing |
14 |
13 |
$46.14 |
| A7014 |
Compressor nondispos filter |
96 |
84 |
$17.08 |