| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1392 |
Portable oxygen concentrator |
9,559 |
8,104 |
$384K |
| K0739 |
Repair/svc dme non-oxygen eq |
674 |
631 |
$128K |
| E2402 |
Neg press wound therapy pump |
26 |
24 |
$35K |
| E1390 |
Oxygen concentrator |
32,687 |
31,866 |
$18K |
| K0001 |
Standard wheelchair |
31,740 |
30,749 |
$15K |
| E0570 |
Nebulizer with compression |
35,373 |
34,904 |
$11K |
| E0601 |
Cont airway pressure device |
32,973 |
32,215 |
$9K |
| E0466 |
Home vent non-invasive inter |
30 |
24 |
$7K |
| E0562 |
Humidifier heated used w pap |
38,864 |
37,954 |
$6K |
| E0260 |
Hosp bed semi-electr w/ matt |
9,242 |
8,919 |
$6K |
| A7003 |
Nebulizer administration set |
18,525 |
17,673 |
$4K |
| K0003 |
Lightweight wheelchair |
6,314 |
6,089 |
$4K |
| A4216 |
Sterile water/saline, 10 ml |
10,185 |
8,203 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
6,862 |
6,556 |
$3K |
| E0443 |
Portable 02 contents, gas |
7,536 |
4,235 |
$3K |
| E0470 |
Rad w/o backup non-inv intfc |
5,170 |
5,043 |
$2K |
| A4615 |
Cannula nasal |
5,558 |
3,981 |
$2K |
| A4450 |
Non-waterproof tape |
7,116 |
5,982 |
$2K |
| A7030 |
Cpap full face mask |
3,584 |
3,471 |
$2K |
| E0630 |
Patient lift hydraulic |
2,975 |
2,856 |
$2K |
| E0265 |
Hosp bed total electr w/ mat |
2,674 |
2,619 |
$1K |
| E0163 |
Commode chair with fixed arm |
3,225 |
3,119 |
$1K |
| A7038 |
Pos airway pressure filter |
5,590 |
5,358 |
$1K |
| E0255 |
Hospital bed var ht w/ mattr |
3,282 |
3,206 |
$1K |
| E0277 |
Powered pres-redu air mattrs |
1,744 |
1,714 |
$1K |
| A7034 |
Nasal application device |
2,507 |
2,399 |
$1K |
| E0431 |
Portable gaseous 02 |
3,233 |
2,165 |
$1K |
| E0181 |
Press pad alternating w/ pum |
2,053 |
2,036 |
$1K |
| E0635 |
Patient lift electric |
2,205 |
2,114 |
$1K |
| K0006 |
Heavy duty wheelchair |
2,187 |
2,148 |
$915.20 |
| E0165 |
Commode chair with detacharm |
1,755 |
1,728 |
$846.82 |
| K0195 |
Elevating whlchair leg rests |
8,853 |
8,604 |
$770.67 |
| A6402 |
Sterile gauze <= 16 sq in |
7,266 |
5,909 |
$766.05 |
| E0600 |
Suction pump portab hom modl |
1,782 |
1,708 |
$761.00 |
| A7037 |
Pos airway pressure tubing |
5,214 |
5,035 |
$679.12 |
| E0156 |
Walker seat attachment |
3,663 |
3,553 |
$608.08 |
| A6212 |
Foam drg <=16 sq in w/border |
1,525 |
1,258 |
$601.01 |
| A7035 |
Pos airway press headgear |
2,991 |
2,916 |
$597.24 |
| E1038 |
Transport chair pt wt<=300lb |
1,425 |
1,354 |
$531.17 |
| A4351 |
Straight tip urine catheter |
1,315 |
1,238 |
$526.00 |
| E0185 |
Gel pressure mattress pad |
1,237 |
1,226 |
$507.55 |
| A4353 |
Intermittent urinary cath |
1,275 |
1,190 |
$489.89 |
| A6022 |
Collagen drsg>16<=48 sq in |
1,174 |
885 |
$459.35 |
| A4409 |
Ost skn barr convex <=4 sq i |
1,030 |
961 |
$435.47 |
| E0471 |
Rad w/backup non inv intrfc |
690 |
673 |
$407.50 |
| A7015 |
Aerosol mask used w nebulize |
18,488 |
17,649 |
$389.50 |
| A4357 |
Bedside drainage bag |
2,612 |
2,396 |
$379.99 |
| K0800 |
Pov group 1 std up to 300lbs |
629 |
601 |
$358.45 |
| A5120 |
Skin barrier, wipe or swab |
3,266 |
3,037 |
$350.39 |
| E1353 |
Oxygen supplies regulator |
2,029 |
1,821 |
$349.59 |
| A7000 |
Disposable canister for pump |
1,094 |
934 |
$312.73 |
| E0619 |
Apnea monitor w recorder |
638 |
619 |
$262.30 |
| A6446 |
Conform band s w>=3" <5"/yd |
3,726 |
3,074 |
$237.80 |
| E0303 |
Hosp bed hvy dty xtra wide |
489 |
470 |
$235.21 |
| A4385 |
Ost skn barrier sld ext wear |
1,652 |
1,513 |
$225.00 |
| K0823 |
Pwc gp 2 std cap chair |
430 |
418 |
$216.28 |
| A4349 |
Disposable male external cat |
538 |
487 |
$192.21 |
| A6449 |
Lt compres band >=3" <5"/yd |
1,295 |
1,084 |
$190.49 |
| A4927 |
Non-sterile gloves |
857 |
777 |
$183.18 |
| A4338 |
Indwelling catheter latex |
693 |
628 |
$155.36 |
| E0100 |
Cane adjust/fixed with tip |
356 |
343 |
$146.63 |
| A4452 |
Waterproof tape |
1,615 |
1,306 |
$143.46 |
| E0135 |
Walker folding adjust/fixed |
379 |
358 |
$138.89 |
| E0565 |
Compressor air power source |
356 |
345 |
$134.16 |
| A4371 |
Skin barrier powder per oz |
889 |
839 |
$133.41 |
| A7046 |
Repl water chamber, pap dev |
876 |
837 |
$131.05 |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
1,084 |
871 |
$116.53 |
| E1226 |
Manual fully reclining back |
163 |
159 |
$109.99 |
| A4406 |
Pectin based ostomy paste |
1,128 |
1,045 |
$109.06 |
| K0005 |
Ultralightweight wheelchair |
57 |
50 |
$108.83 |
| E0105 |
Cane adjust/fixed quad/3 pro |
241 |
236 |
$107.24 |
| A4358 |
Urinary leg or abdomen bag |
2,190 |
1,998 |
$105.96 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
676 |
646 |
$96.32 |
| A6197 |
Alginate drsg >16 <=48 sq in |
518 |
427 |
$75.68 |
| E0202 |
Phototherapy light w/ photom |
157 |
36 |
$66.22 |
| E0445 |
Oximeter non-invasive |
17 |
12 |
$66.02 |
| A4362 |
Solid skin barrier |
193 |
182 |
$62.78 |
| A6216 |
Non-sterile gauze<=16 sq in |
341 |
292 |
$59.33 |
| A4456 |
Adhesive remover, wipes |
1,988 |
1,863 |
$56.17 |
| A4425 |
Ost pch drain for barrier fl |
1,180 |
1,089 |
$55.58 |
| A4310 |
Insert tray w/o bag/cath |
772 |
711 |
$54.67 |
| E0149 |
Heavy duty wheeled walker |
174 |
161 |
$48.59 |
| E0424 |
Stationary compressed gas 02 |
120 |
114 |
$48.59 |
| A4311 |
Catheter w/o bag 2-way latex |
105 |
103 |
$44.29 |
| A4624 |
Tracheal suction tube |
110 |
102 |
$43.70 |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
419 |
364 |
$42.84 |
| E1031 |
Rollabout chair with casters |
13 |
12 |
$42.74 |
| A6240 |
Hydrocolld drg filler paste |
338 |
287 |
$39.67 |
| E0621 |
Patient lift sling or seat |
172 |
168 |
$38.27 |
| A7526 |
Tracheostomy tube collar |
210 |
168 |
$36.34 |
| A5061 |
Pouch drainable w barrier at |
203 |
196 |
$29.24 |
| A4333 |
Urinary cath anchor device |
369 |
325 |
$22.22 |
| A4394 |
Ostomy pouch liq deodorant |
216 |
207 |
$20.91 |
| A4604 |
Tubing with heating element |
43 |
41 |
$16.77 |
| A4628 |
Oropharyngeal suction cath |
53 |
49 |
$16.02 |
| A4606 |
Oxygen probe used w oximeter |
32 |
25 |
$13.76 |
| A5063 |
Drain ostomy pouch w/flange |
303 |
285 |
$13.01 |
| A4407 |
Ext wear ost skn barr <=4sq" |
67 |
62 |
$12.90 |
| A6447 |
Conform band s w >=5"/yd |
503 |
464 |
$10.75 |
| A7002 |
Tubing used w suction pump |
102 |
99 |
$9.30 |
| A6210 |
Foam drg >16<=48 sq in w/o b |
30 |
27 |
$6.88 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
57 |
50 |
$6.45 |
| E2601 |
Gen w/c cushion wdth < 22 in |
27 |
26 |
$5.59 |
| K0007 |
Extra heavy duty wheelchair |
12 |
12 |
$5.16 |
| E0618 |
Apnea monitor |
12 |
12 |
$5.16 |
| A4616 |
Tubing (oxygen) per foot |
16 |
13 |
$5.16 |
| A4670 |
Automatic bp monitor, dial |
13 |
12 |
$5.16 |
| A7039 |
Filter, non disposable w pap |
12 |
12 |
$2.58 |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
12 |
12 |
$1.72 |
| A6266 |
Impreg gauze no h20/sal/yard |
28 |
24 |
$1.29 |
| A4402 |
Lubricant per ounce |
42 |
37 |
$1.29 |
| A6457 |
Tubular dressing |
16 |
15 |
$0.86 |