| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
27,955 |
27,648 |
$1.43M |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,501 |
1,432 |
$1.21M |
| B4149 |
Ef blenderized foods |
2,874 |
2,506 |
$1.18M |
| B4035 |
Enteral feed supp pump per d |
3,401 |
3,264 |
$723K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,328 |
2,253 |
$294K |
| B4034 |
Enter feed supkit syr by day |
2,532 |
2,460 |
$260K |
| K0001 |
Standard wheelchair |
11,863 |
11,765 |
$257K |
| E0114 |
Crutch underarm pair no wood |
5,237 |
5,216 |
$245K |
| L4361 |
Pneuma/vac walk boot pre ots |
1,279 |
1,278 |
$234K |
| E0260 |
Hosp bed semi-electr w/ matt |
7,188 |
7,056 |
$224K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
708 |
676 |
$212K |
| E0431 |
Portable gaseous 02 |
21,960 |
21,664 |
$194K |
| E0143 |
Walker folding wheeled w/o s |
4,174 |
4,116 |
$182K |
| E0570 |
Nebulizer with compression |
5,866 |
5,684 |
$153K |
| L3670 |
So acro/clav can web pre ots |
2,069 |
2,054 |
$139K |
| L4360 |
Pneumat walking boot pre cst |
894 |
882 |
$137K |
| E0445 |
Oximeter non-invasive |
683 |
683 |
$116K |
| E0600 |
Suction pump portab hom modl |
2,456 |
2,432 |
$98K |
| A7030 |
Cpap full face mask |
2,270 |
2,217 |
$90K |
| B4152 |
Ef calorie dense>/=1.5kcal |
550 |
527 |
$86K |
| E0990 |
Wheelchair elevating leg res |
1,387 |
1,359 |
$83K |
| L3908 |
Who cock-up nonmolde pre ots |
1,890 |
1,867 |
$68K |
| B9002 |
Enter nutr inf pump any type |
632 |
631 |
$61K |
| E0470 |
Rad w/o backup non-inv intfc |
704 |
702 |
$59K |
| E0601 |
Cont airway pressure device |
2,121 |
2,097 |
$57K |
| E0630 |
Patient lift hydraulic |
1,642 |
1,623 |
$57K |
| L3809 |
Whfo w/o joints pre ots |
439 |
433 |
$38K |
| A4627 |
Spacer bag/reservoir |
3,149 |
3,146 |
$36K |
| E0165 |
Commode chair with detacharm |
1,010 |
1,005 |
$30K |
| E0776 |
Iv pole |
1,835 |
1,829 |
$30K |
| A7005 |
Nondisposable nebulizer set |
1,974 |
1,969 |
$30K |
| K0003 |
Lightweight wheelchair |
2,757 |
2,702 |
$28K |
| E0149 |
Heavy duty wheeled walker |
983 |
952 |
$26K |
| E0562 |
Humidifier heated used w pap |
1,369 |
1,364 |
$25K |
| A7526 |
Tracheostomy tube collar |
402 |
395 |
$22K |
| A7000 |
Disposable canister for pump |
1,143 |
1,115 |
$22K |
| A7035 |
Pos airway press headgear |
2,226 |
2,181 |
$21K |
| L1830 |
Ko immob canvas long pre ots |
350 |
349 |
$16K |
| E2601 |
Gen w/c cushion wdth < 22 in |
604 |
600 |
$16K |
| E0465 |
Home vent invasive interface |
24 |
24 |
$13K |
| A4604 |
Tubing with heating element |
1,976 |
1,919 |
$13K |
| A4629 |
Tracheostomy care kit |
113 |
113 |
$11K |
| A7031 |
Replacement facemask interfa |
1,071 |
1,067 |
$11K |
| K0823 |
Pwc gp 2 std cap chair |
269 |
269 |
$11K |
| E0181 |
Press pad alternating w/ pum |
902 |
885 |
$9K |
| E0163 |
Commode chair with fixed arm |
131 |
131 |
$8K |
| E1028 |
W/c manual swingaway |
448 |
430 |
$8K |
| A7034 |
Nasal application device |
317 |
311 |
$7K |
| K0195 |
Elevating whlchair leg rests |
740 |
735 |
$7K |
| A7002 |
Tubing used w suction pump |
1,271 |
1,215 |
$7K |
| A7037 |
Pos airway pressure tubing |
512 |
507 |
$7K |
| E0277 |
Powered pres-redu air mattrs |
51 |
51 |
$7K |
| A4624 |
Tracheal suction tube |
65 |
64 |
$7K |
| E1392 |
Portable oxygen concentrator |
336 |
336 |
$7K |
| A7046 |
Repl water chamber, pap dev |
1,306 |
1,273 |
$7K |
| A7038 |
Pos airway pressure filter |
3,171 |
3,097 |
$6K |
| E0156 |
Walker seat attachment |
806 |
781 |
$6K |
| K0006 |
Heavy duty wheelchair |
398 |
373 |
$6K |
| L3260 |
Ambulatory surgical boot eac |
593 |
592 |
$6K |
| E0118 |
Crutch substitute |
53 |
53 |
$5K |
| E0565 |
Compressor air power source |
158 |
158 |
$5K |
| K0053 |
Elevate footrest articulate |
276 |
208 |
$4K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
478 |
478 |
$4K |
| K0007 |
Extra heavy duty wheelchair |
68 |
66 |
$4K |
| E0303 |
Hosp bed hvy dty xtra wide |
53 |
51 |
$4K |
| B4155 |
Ef incomplete/modular |
76 |
73 |
$3K |
| L1820 |
Ko elas w/ condyle pads & jo |
28 |
28 |
$3K |
| K0738 |
Portable gas oxygen system |
220 |
219 |
$2K |
| B4150 |
Ef complet w/intact nutrient |
13 |
12 |
$2K |
| A4623 |
Tracheostomy inner cannula |
25 |
25 |
$2K |
| L4350 |
Ankle control ortho pre ots |
25 |
25 |
$2K |
| A7003 |
Nebulizer administration set |
798 |
796 |
$1K |
| E0910 |
Trapeze bar attached to bed |
199 |
198 |
$1K |
| A4606 |
Oxygen probe used w oximeter |
13 |
13 |
$1K |
| L1902 |
Afo ankle gauntlet pre ots |
13 |
13 |
$1K |
| A4628 |
Oropharyngeal suction cath |
101 |
101 |
$1K |
| E0184 |
Dry pressure mattress |
136 |
135 |
$806.72 |
| A7013 |
Disposable compressor filter |
315 |
315 |
$749.59 |
| A7032 |
Replacement nasal cushion |
38 |
38 |
$543.06 |
| A7520 |
Trach/laryn tube non-cuffed |
13 |
13 |
$261.44 |
| A4615 |
Cannula nasal |
41 |
41 |
$168.00 |
| A6402 |
Sterile gauze <= 16 sq in |
13 |
13 |
$84.76 |