| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer with compression |
6,456 |
6,169 |
$386K |
| T4534 |
Youth size pull-on |
1,698 |
1,661 |
$256K |
| E1390 |
Oxygen concentrator |
3,828 |
3,662 |
$241K |
| T4535 |
Disposable liner/shield/pad |
2,802 |
2,678 |
$180K |
| T4527 |
Adult size pull-on lg |
1,832 |
1,774 |
$177K |
| T4526 |
Adult size pull-on med |
1,888 |
1,802 |
$171K |
| T4528 |
Adult size pull-on xl |
1,498 |
1,395 |
$160K |
| T4523 |
Adult size brief/diaper lg |
790 |
771 |
$119K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,969 |
3,710 |
$119K |
| T4541 |
Large disposable underpad |
4,350 |
4,156 |
$93K |
| E0601 |
Cont airway pressure device |
1,624 |
1,518 |
$78K |
| K0003 |
Lightweight wheelchair |
2,638 |
2,540 |
$67K |
| T4537 |
Reusable underpad bed size |
2,112 |
2,026 |
$66K |
| A7005 |
Nondisposable nebulizer set |
2,688 |
2,610 |
$53K |
| A4351 |
Straight tip urine catheter |
452 |
430 |
$49K |
| T4522 |
Adult size brief/diaper med |
320 |
314 |
$46K |
| A4927 |
Non-sterile gloves |
2,716 |
2,581 |
$40K |
| E0431 |
Portable gaseous 02 |
2,994 |
2,873 |
$36K |
| E0619 |
Apnea monitor w recorder |
216 |
213 |
$34K |
| B4034 |
Enter feed supkit syr by day |
325 |
278 |
$20K |
| A4595 |
Tens suppl 2 lead per month |
313 |
288 |
$18K |
| E0562 |
Humidifier heated used w pap |
100 |
99 |
$15K |
| T4540 |
Reusable underpad chair size |
556 |
552 |
$14K |
| E0114 |
Crutch underarm pair no wood |
359 |
349 |
$11K |
| A6402 |
Sterile gauze <= 16 sq in |
905 |
819 |
$10K |
| K0195 |
Elevating whlchair leg rests |
1,982 |
1,937 |
$9K |
| T4543 |
Adult disp brief/diap abv xl |
25 |
25 |
$7K |
| A4452 |
Waterproof tape |
651 |
590 |
$7K |
| E0971 |
Wheelchair anti-tipping devi |
822 |
464 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
89 |
86 |
$6K |
| A7030 |
Cpap full face mask |
58 |
57 |
$5K |
| L3908 |
Who cock-up nonmolde pre ots |
143 |
117 |
$5K |
| A7037 |
Pos airway pressure tubing |
240 |
235 |
$5K |
| A7035 |
Pos airway press headgear |
240 |
234 |
$4K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
51 |
50 |
$4K |
| A7038 |
Pos airway pressure filter |
287 |
277 |
$3K |
| E0181 |
Press pad alternating w/ pum |
486 |
463 |
$2K |
| A4357 |
Bedside drainage bag |
1,144 |
1,044 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,670 |
1,622 |
$2K |
| A6446 |
Conform band s w>=3" <5"/yd |
64 |
59 |
$2K |
| B4152 |
Ef calorie dense>/=1.5kcal |
25 |
24 |
$2K |
| E0630 |
Patient lift hydraulic |
93 |
88 |
$1K |
| K0001 |
Standard wheelchair |
24 |
24 |
$768.20 |
| A7034 |
Nasal application device |
12 |
12 |
$701.74 |
| A4406 |
Pectin based ostomy paste |
157 |
149 |
$645.69 |
| A5063 |
Drain ostomy pouch w/flange |
38 |
37 |
$601.62 |
| E0978 |
W/c acc,saf belt pelv strap |
27 |
26 |
$476.91 |
| E0445 |
Oximeter non-invasive |
13 |
12 |
$322.00 |
| A4340 |
Indwelling catheter special |
185 |
165 |
$312.35 |
| E2601 |
Gen w/c cushion wdth < 22 in |
13 |
12 |
$308.44 |
| A4358 |
Urinary leg or abdomen bag |
82 |
78 |
$256.68 |
| A4402 |
Lubricant per ounce |
54 |
51 |
$248.13 |
| A7039 |
Filter, non disposable w pap |
33 |
29 |
$218.12 |
| A4310 |
Insert tray w/o bag/cath |
190 |
158 |
$181.97 |
| A5120 |
Skin barrier, wipe or swab |
13 |
13 |
$66.04 |
| A4334 |
Urinary cath leg strap |
36 |
36 |
$14.87 |
| A4217 |
Sterile water/saline, 500 ml |
39 |
39 |
$0.00 |
| A4354 |
Cath insertion tray w/bag |
14 |
12 |
$0.00 |