| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
24,323 |
23,798 |
$160K |
| K0001 |
Standard wheelchair |
19,127 |
18,873 |
$33K |
| E0431 |
Portable gaseous 02 |
25,184 |
23,564 |
$26K |
| T4541 |
Large disposable underpad |
58,195 |
55,925 |
$24K |
| E0445 |
Oximeter non-invasive |
1,317 |
1,311 |
$20K |
| E0601 |
Cont airway pressure device |
18,110 |
18,076 |
$13K |
| T4527 |
Adult size pull-on lg |
20,174 |
19,463 |
$13K |
| E0143 |
Walker folding wheeled w/o s |
5,396 |
5,333 |
$10K |
| E0471 |
Rad w/backup non inv intrfc |
1,029 |
1,029 |
$8K |
| A4670 |
Automatic bp monitor, dial |
7,586 |
7,558 |
$8K |
| T4535 |
Disposable liner/shield/pad |
33,131 |
31,618 |
$8K |
| K0007 |
Extra heavy duty wheelchair |
2,125 |
2,090 |
$7K |
| E0562 |
Humidifier heated used w pap |
20,761 |
20,714 |
$7K |
| E0570 |
Nebulizer with compression |
2,650 |
2,644 |
$7K |
| E0600 |
Suction pump portab hom modl |
1,752 |
1,689 |
$7K |
| T4526 |
Adult size pull-on med |
26,571 |
25,731 |
$6K |
| E0470 |
Rad w/o backup non-inv intfc |
2,097 |
2,090 |
$6K |
| T4523 |
Adult size brief/diaper lg |
11,953 |
11,466 |
$6K |
| T4528 |
Adult size pull-on xl |
12,468 |
11,911 |
$6K |
| T4522 |
Adult size brief/diaper med |
10,421 |
9,999 |
$6K |
| K0195 |
Elevating whlchair leg rests |
6,270 |
6,115 |
$5K |
| A7000 |
Disposable canister for pump |
855 |
692 |
$5K |
| K0003 |
Lightweight wheelchair |
2,348 |
2,338 |
$4K |
| A4353 |
Intermittent urinary cath |
993 |
964 |
$4K |
| E0295 |
Hosp bed semi-elect w/o matt |
2,824 |
2,814 |
$4K |
| A7034 |
Nasal application device |
2,941 |
2,898 |
$3K |
| E0482 |
Cough stimulating device |
26 |
25 |
$3K |
| E0277 |
Powered pres-redu air mattrs |
1,111 |
1,096 |
$3K |
| A7030 |
Cpap full face mask |
1,395 |
1,377 |
$3K |
| A4409 |
Ost skn barr convex <=4 sq i |
1,618 |
1,548 |
$3K |
| T4524 |
Adult size brief/diaper xl |
6,382 |
6,182 |
$3K |
| E0156 |
Walker seat attachment |
3,063 |
3,009 |
$3K |
| E1226 |
Manual fully reclining back |
729 |
710 |
$2K |
| A7035 |
Pos airway press headgear |
4,269 |
4,180 |
$2K |
| T4531 |
Ped size pull-on sm/med |
3,071 |
2,955 |
$2K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,947 |
1,863 |
$2K |
| E0630 |
Patient lift hydraulic |
1,059 |
1,058 |
$2K |
| A4425 |
Ost pch drain for barrier fl |
1,553 |
1,484 |
$2K |
| A4385 |
Ost skn barrier sld ext wear |
2,033 |
1,959 |
$2K |
| A6250 |
Skin seal protect moisturizr |
9,787 |
9,087 |
$2K |
| E0163 |
Commode chair with fixed arm |
773 |
772 |
$2K |
| E0603 |
Electric breast pump |
1,187 |
1,185 |
$2K |
| A7031 |
Replacement facemask interfa |
1,218 |
1,198 |
$1K |
| A7037 |
Pos airway pressure tubing |
3,330 |
3,312 |
$1K |
| T4521 |
Adult size brief/diaper sm |
1,399 |
1,359 |
$1K |
| E0303 |
Hosp bed hvy dty xtra wide |
296 |
290 |
$1K |
| B4035 |
Enteral feed supp pump per d |
1,896 |
1,719 |
$897.02 |
| T4534 |
Youth size pull-on |
4,421 |
4,239 |
$813.09 |
| B4154 |
Ef spec metabolic noninherit |
4,208 |
3,990 |
$803.34 |
| E0305 |
Rails bed side half length |
3,221 |
3,165 |
$778.71 |
| E1038 |
Transport chair pt wt<=300lb |
1,227 |
1,214 |
$750.18 |
| E0240 |
Bath/shower chair |
3,198 |
3,184 |
$742.96 |
| A7038 |
Pos airway pressure filter |
3,406 |
3,373 |
$669.03 |
| A4927 |
Non-sterile gloves |
22,389 |
21,511 |
$633.58 |
| A4604 |
Tubing with heating element |
636 |
632 |
$627.26 |
| T4530 |
Ped size brief/diaper lg |
2,422 |
2,361 |
$617.44 |
| T4544 |
Adlt disp und/pull on abv xl |
2,310 |
2,214 |
$538.32 |
| E0114 |
Crutch underarm pair no wood |
81 |
81 |
$523.56 |
| E0260 |
Hosp bed semi-electr w/ matt |
42 |
42 |
$465.42 |
| A7015 |
Aerosol mask used w nebulize |
1,781 |
1,765 |
$463.82 |
| A6402 |
Sterile gauze <= 16 sq in |
2,460 |
2,344 |
$438.70 |
| A4351 |
Straight tip urine catheter |
2,298 |
2,217 |
$434.07 |
| E0247 |
Trans bench w/wo comm open |
179 |
177 |
$374.54 |
| B4155 |
Ef incomplete/modular |
1,104 |
1,025 |
$325.38 |
| E0245 |
Tub stool or bench |
26 |
26 |
$280.02 |
| T4533 |
Youth size brief/diaper |
394 |
380 |
$268.97 |
| A7046 |
Repl water chamber, pap dev |
827 |
814 |
$267.75 |
| A4624 |
Tracheal suction tube |
303 |
283 |
$243.83 |
| A4357 |
Bedside drainage bag |
1,064 |
1,016 |
$233.80 |
| E0310 |
Rails bed side full length |
634 |
634 |
$224.58 |
| B9998 |
Enteral supp not otherwise c |
2,415 |
2,273 |
$221.42 |
| E0978 |
W/c acc,saf belt pelv strap |
1,115 |
1,093 |
$216.79 |
| A4456 |
Adhesive remover, wipes |
1,712 |
1,657 |
$207.13 |
| E0971 |
Wheelchair anti-tipping devi |
723 |
707 |
$191.12 |
| T4525 |
Adult size pull-on sm |
4,839 |
4,643 |
$181.82 |
| A7033 |
Replacement nasal pillows |
81 |
80 |
$164.77 |
| E0118 |
Crutch substitute |
1,168 |
1,164 |
$157.44 |
| B9002 |
Enter nutr inf pump any type |
1,130 |
1,106 |
$147.63 |
| E0100 |
Cane adjust/fixed with tip |
785 |
782 |
$143.81 |
| A6216 |
Non-sterile gauze<=16 sq in |
519 |
500 |
$138.12 |
| B4150 |
Ef complet w/intact nutrient |
6,862 |
6,565 |
$122.85 |
| A5120 |
Skin barrier, wipe or swab |
1,921 |
1,860 |
$112.83 |
| A4358 |
Urinary leg or abdomen bag |
1,052 |
1,013 |
$95.36 |
| B4088 |
Gastro/jejuno tube, low-pro |
1,433 |
1,409 |
$73.67 |
| A4216 |
Sterile water/saline, 10 ml |
133 |
130 |
$61.79 |
| B4160 |
Ef ped caloric dense>/=0.7kc |
14,926 |
14,233 |
$50.70 |
| E0966 |
Wheelchair head rest extensi |
608 |
597 |
$41.97 |
| A7526 |
Tracheostomy tube collar |
51 |
49 |
$38.12 |
| A4628 |
Oropharyngeal suction cath |
873 |
829 |
$34.64 |
| E0776 |
Iv pole |
541 |
539 |
$31.27 |
| A7002 |
Tubing used w suction pump |
356 |
337 |
$26.43 |
| E0244 |
Toilet seat raised |
25 |
25 |
$24.81 |
| A4310 |
Insert tray w/o bag/cath |
74 |
66 |
$21.99 |
| A7520 |
Trach/laryn tube non-cuffed |
64 |
61 |
$20.40 |
| A4394 |
Ostomy pouch liq deodorant |
1,089 |
1,058 |
$10.50 |
| A4406 |
Pectin based ostomy paste |
671 |
637 |
$9.66 |
| A4450 |
Non-waterproof tape |
1,246 |
1,199 |
$8.91 |
| A4213 |
20+ cc syringe only |
1,249 |
1,195 |
$5.73 |
| A4335 |
Incontinence supply |
1,023 |
982 |
$1.47 |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,645 |
2,476 |
$0.66 |
| A4371 |
Skin barrier powder per oz |
688 |
659 |
$0.63 |
| A4322 |
Irrigation syringe |
1,493 |
1,446 |
$0.00 |
| K0004 |
High strength ltwt whlchr |
87 |
87 |
$0.00 |
| T4543 |
Adult disp brief/diap abv xl |
1,471 |
1,409 |
$0.00 |
| E0105 |
Cane adjust/fixed quad/3 pro |
16 |
14 |
$0.00 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
155 |
148 |
$0.00 |
| E1399 |
Durable medical equipment mi |
269 |
265 |
$0.00 |
| A9270 |
Non-covered item or service |
4,312 |
4,139 |
$0.00 |
| T4536 |
Reusable pull-on any size |
89 |
85 |
$0.00 |
| A4338 |
Indwelling catheter latex |
54 |
50 |
$0.00 |
| T4537 |
Reusable underpad bed size |
86 |
84 |
$0.00 |
| A4520 |
Incontinence garment anytype |
12 |
12 |
$0.00 |
| A5063 |
Drain ostomy pouch w/flange |
95 |
92 |
$0.00 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
13 |
12 |
$0.00 |
| E0730 |
Tens four lead |
25 |
25 |
$0.00 |
| E0297 |
Hosp bed total elect w/o mat |
12 |
12 |
$0.00 |
| A4349 |
Disposable male external cat |
36 |
36 |
$0.00 |
| A7032 |
Replacement nasal cushion |
14 |
14 |
$0.00 |
| A6443 |
Conform band n/s w>=3"<5"/yd |
12 |
12 |
$0.00 |
| E0241 |
Bath tub wall rail |
12 |
12 |
$0.00 |
| K0052 |
Swingaway detach ftrest repl |
2,092 |
2,058 |
$0.00 |
| T4532 |
Ped size pull-on lg |
619 |
587 |
$0.00 |
| A4367 |
Ostomy belt |
345 |
337 |
$0.00 |
| B4158 |
Ef ped complete intact nut |
931 |
896 |
$0.00 |
| A4649 |
Surgical supplies |
316 |
292 |
$0.00 |
| E0184 |
Dry pressure mattress |
442 |
436 |
$0.00 |
| A4402 |
Lubricant per ounce |
482 |
457 |
$0.00 |
| T4542 |
Small disposable underpad |
272 |
259 |
$0.00 |
| A7039 |
Filter, non disposable w pap |
121 |
120 |
$0.00 |
| A4452 |
Waterproof tape |
51 |
50 |
$0.00 |