| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
62,467 |
45,662 |
$3.53M |
| E1390 |
Oxygen concentrator |
33,873 |
31,089 |
$2.85M |
| E0603 |
Electric breast pump |
15,911 |
13,888 |
$2.80M |
| T4526 |
Adult size pull-on med |
35,227 |
32,813 |
$2.80M |
| T4527 |
Adult size pull-on lg |
31,082 |
28,907 |
$2.72M |
| T4535 |
Disposable liner/shield/pad |
43,489 |
40,439 |
$2.41M |
| T4528 |
Adult size pull-on xl |
19,912 |
18,498 |
$2.13M |
| E0601 |
Cont airway pressure device |
42,087 |
39,412 |
$1.84M |
| E0466 |
Home vent non-invasive inter |
2,217 |
1,977 |
$1.74M |
| S8121 |
O2 contents liquid lb |
13,687 |
3,780 |
$1.24M |
| T4541 |
Large disposable underpad |
32,563 |
29,992 |
$1.21M |
| A7030 |
Cpap full face mask |
11,607 |
10,806 |
$1.18M |
| L4361 |
Pneuma/vac walk boot pre ots |
5,667 |
5,060 |
$1.05M |
| L3020 |
Foot longitud/metatarsal sup |
4,029 |
2,849 |
$1.03M |
| A4604 |
Tubing with heating element |
23,120 |
21,475 |
$938K |
| A7034 |
Nasal application device |
13,371 |
12,454 |
$877K |
| K1005 |
Disp col sto bag breast milk |
16,484 |
9,252 |
$816K |
| E0562 |
Humidifier heated used w pap |
10,902 |
9,667 |
$804K |
| E0570 |
Nebulizer with compression |
20,589 |
19,644 |
$797K |
| E0439 |
Stationary liquid 02 |
6,968 |
5,974 |
$627K |
| T4523 |
Adult size brief/diaper lg |
4,660 |
4,284 |
$580K |
| K0108 |
W/c component-accessory nos |
3,940 |
1,466 |
$580K |
| A9276 |
Disposable sensor, cgm sys |
2,920 |
1,804 |
$576K |
| A7031 |
Replacement facemask interfa |
12,503 |
10,638 |
$552K |
| A7035 |
Pos airway press headgear |
22,417 |
21,011 |
$503K |
| A4353 |
Intermittent urinary cath |
406 |
376 |
$462K |
| A6549 |
Grad com garm noc day use |
1,443 |
906 |
$458K |
| T4543 |
Adult disp brief/diap abv xl |
2,216 |
2,022 |
$455K |
| A9274 |
Ext amb insulin delivery sys |
747 |
712 |
$443K |
| A4351 |
Straight tip urine catheter |
2,457 |
2,067 |
$434K |
| E0700 |
Safety equipment |
5,650 |
5,474 |
$428K |
| E2402 |
Neg press wound therapy pump |
675 |
367 |
$408K |
| A4230 |
Infus insulin pump non needl |
2,052 |
1,911 |
$405K |
| T4525 |
Adult size pull-on sm |
5,086 |
4,706 |
$402K |
| L3010 |
Foot longitudinal arch suppo |
1,990 |
1,374 |
$393K |
| A4287 |
Disp col sto bag breast milk |
6,787 |
4,119 |
$384K |
| A7032 |
Replacement nasal cushion |
9,549 |
8,148 |
$376K |
| E0470 |
Rad w/o backup non-inv intfc |
3,664 |
3,430 |
$368K |
| A4927 |
Non-sterile gloves |
16,223 |
14,715 |
$353K |
| E1399 |
Durable medical equipment mi |
2,251 |
1,582 |
$336K |
| E0260 |
Hosp bed semi-electr w/ matt |
6,889 |
5,980 |
$326K |
| E0114 |
Crutch underarm pair no wood |
7,454 |
7,086 |
$318K |
| A7005 |
Nondisposable nebulizer set |
16,711 |
12,226 |
$318K |
| T4534 |
Youth size pull-on |
2,821 |
2,599 |
$308K |
| L3908 |
Who cock-up nonmolde pre ots |
5,912 |
5,175 |
$297K |
| T4522 |
Adult size brief/diaper med |
2,748 |
2,583 |
$291K |
| T4544 |
Adlt disp und/pull on abv xl |
1,762 |
1,571 |
$288K |
| A4627 |
Spacer bag/reservoir |
10,726 |
9,376 |
$288K |
| E1392 |
Portable oxygen concentrator |
8,946 |
8,277 |
$281K |
| T4524 |
Adult size brief/diaper xl |
1,987 |
1,798 |
$273K |
| A4385 |
Ost skn barrier sld ext wear |
3,232 |
2,752 |
$273K |
| A5500 |
Diab shoe for density insert |
3,860 |
2,061 |
$254K |
| A4670 |
Automatic bp monitor, dial |
3,822 |
3,636 |
$248K |
| E0118 |
Crutch substitute |
5,514 |
5,287 |
$239K |
| L2630 |
Pelvic control band & belt u |
1,043 |
925 |
$233K |
| K0001 |
Standard wheelchair |
10,476 |
9,445 |
$229K |
| A6212 |
Foam drg <=16 sq in w/border |
1,543 |
1,241 |
$225K |
| L2275 |
Plastic mod low ext pad/line |
2,317 |
1,287 |
$220K |
| E0240 |
Bath/shower chair |
2,077 |
1,805 |
$218K |
| L2280 |
Molded inner boot |
572 |
313 |
$214K |
| E0652 |
Pneum compres w/cal pressure |
427 |
419 |
$196K |
| K0739 |
Repair/svc dme non-oxygen eq |
4,393 |
3,549 |
$190K |
| E0143 |
Walker folding wheeled w/o s |
4,484 |
3,913 |
$188K |
| A7038 |
Pos airway pressure filter |
39,769 |
35,071 |
$182K |
| K0738 |
Portable gas oxygen system |
6,380 |
5,805 |
$176K |
| A7033 |
Replacement nasal pillows |
4,019 |
3,809 |
$163K |
| E1028 |
W/c manual swingaway |
2,292 |
1,104 |
$163K |
| A7046 |
Repl water chamber, pap dev |
12,518 |
11,789 |
$159K |
| L1902 |
Afo ankle gauntlet pre ots |
2,589 |
2,418 |
$158K |
| E0604 |
Hosp grade elec breast pump |
3,387 |
3,025 |
$158K |
| E0434 |
Portable liquid 02 |
7,026 |
6,288 |
$154K |
| E0431 |
Portable gaseous 02 |
9,888 |
9,177 |
$154K |
| L3809 |
Whfo w/o joints pre ots |
2,409 |
2,059 |
$148K |
| L1820 |
Ko elas w/ condyle pads & jo |
1,255 |
1,113 |
$148K |
| A9277 |
External transmitter, cgm |
525 |
475 |
$147K |
| E0245 |
Tub stool or bench |
1,501 |
1,414 |
$146K |
| S1040 |
Cranial remolding orthosis |
54 |
54 |
$146K |
| E0444 |
Portable 02 contents, liquid |
3,366 |
3,121 |
$145K |
| E0442 |
Stationary o2 contents, liq |
3,226 |
2,874 |
$143K |
| E0745 |
Neuromuscular stim for shock |
1,529 |
1,417 |
$135K |
| A6530 |
Compression stocking bk18-30 |
3,536 |
2,566 |
$126K |
| A4232 |
Syringe w/needle insulin 3cc |
2,408 |
2,245 |
$125K |
| E0471 |
Rad w/backup non inv intrfc |
519 |
493 |
$124K |
| A4224 |
Supply insulin inf cath/wk |
1,616 |
1,097 |
$108K |
| E0973 |
W/ch access det adj armrest |
6,360 |
3,073 |
$107K |
| E2510 |
Sgd w multi methods msg/accs |
26 |
26 |
$102K |
| A4467 |
Belt strap sleev grmnt cover |
2,917 |
2,676 |
$98K |
| A5057 |
1 pc ost pou w built-in conv |
552 |
476 |
$98K |
| L1960 |
Afo pos solid ank plastic mo |
197 |
109 |
$89K |
| E0630 |
Patient lift hydraulic |
1,748 |
1,549 |
$85K |
| K0003 |
Lightweight wheelchair |
1,980 |
1,816 |
$80K |
| A4407 |
Ext wear ost skn barr <=4sq" |
703 |
578 |
$75K |
| S8120 |
O2 contents gas cubic ft |
634 |
420 |
$74K |
| A4352 |
Coude tip urinary catheter |
150 |
129 |
$74K |
| A7037 |
Pos airway pressure tubing |
3,626 |
3,387 |
$68K |
| A6197 |
Alginate drsg >16 <=48 sq in |
178 |
142 |
$67K |
| L1970 |
Afo plastic molded w/ankle j |
134 |
86 |
$67K |
| E0202 |
Phototherapy light w/ photom |
363 |
270 |
$66K |
| A5514 |
Mult den insert dir carv/cam |
853 |
502 |
$62K |
| L2820 |
Soft interface below knee se |
1,079 |
612 |
$58K |
| A4394 |
Ostomy pouch liq deodorant |
1,640 |
1,429 |
$57K |
| A4239 |
Non-adju cgm supply allow |
344 |
281 |
$56K |
| E0443 |
Portable 02 contents, gas |
1,437 |
1,318 |
$55K |
| A4225 |
Sup/ext insulin inf pump syr |
1,588 |
1,252 |
$52K |
| A4217 |
Sterile water/saline, 500 ml |
1,462 |
1,039 |
$51K |
| E1161 |
Manual adult wc w tiltinspac |
127 |
76 |
$50K |
| E0627 |
Seat lift mech, electric any |
217 |
202 |
$50K |
| E0971 |
Wheelchair anti-tipping devi |
5,918 |
2,907 |
$48K |
| L4350 |
Ankle control ortho pre ots |
863 |
778 |
$48K |
| E0445 |
Oximeter non-invasive |
299 |
268 |
$44K |
| A4357 |
Bedside drainage bag |
2,923 |
2,502 |
$42K |
| A4452 |
Waterproof tape |
1,666 |
1,373 |
$42K |
| E0261 |
Hosp bed semi-electr w/o mat |
715 |
630 |
$42K |
| L1830 |
Ko immob canvas long pre ots |
733 |
695 |
$41K |
| A7039 |
Filter, non disposable w pap |
5,015 |
4,560 |
$40K |
| E0203 |
Therapeutic lightbox tabletp |
282 |
270 |
$40K |
| A4362 |
Solid skin barrier |
713 |
615 |
$38K |
| L1907 |
Afo supramalleolar custom |
88 |
49 |
$38K |
| K0195 |
Elevating whlchair leg rests |
3,009 |
2,721 |
$37K |
| A6446 |
Conform band s w>=3" <5"/yd |
1,263 |
1,031 |
$37K |
| A4409 |
Ost skn barr convex <=4 sq i |
300 |
273 |
$35K |
| E0955 |
Cushioned headrest |
506 |
382 |
$33K |
| L1833 |
Ko adj jnt pos r sup pre ots |
90 |
83 |
$31K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
270 |
249 |
$30K |
| E0244 |
Toilet seat raised |
664 |
612 |
$30K |
| A5513 |
Multi den insert custom mold |
471 |
315 |
$29K |
| E0156 |
Walker seat attachment |
2,102 |
1,925 |
$28K |
| E0100 |
Cane adjust/fixed with tip |
1,449 |
1,373 |
$27K |
| L4387 |
Non-pneum walk boot pre ots |
153 |
149 |
$24K |
| A4565 |
Slings |
3,050 |
2,805 |
$24K |
| A6216 |
Non-sterile gauze<=16 sq in |
2,871 |
2,570 |
$23K |
| L3260 |
Ambulatory surgical boot eac |
2,600 |
2,413 |
$23K |
| A6533 |
Gc stocking thighlngth 18-30 |
454 |
332 |
$21K |
| L1812 |
Ko elastic w/joints pre ots |
347 |
319 |
$21K |
| E0730 |
Tens four lead |
925 |
870 |
$21K |
| A7015 |
Aerosol mask used w nebulize |
13,968 |
11,644 |
$20K |
| A4358 |
Urinary leg or abdomen bag |
1,920 |
1,563 |
$20K |
| A7000 |
Disposable canister for pump |
1,290 |
1,102 |
$20K |
| A5120 |
Skin barrier, wipe or swab |
2,022 |
1,761 |
$19K |
| E2601 |
Gen w/c cushion wdth < 22 in |
488 |
452 |
$18K |
| K0007 |
Extra heavy duty wheelchair |
182 |
167 |
$18K |
| E0978 |
W/c acc,saf belt pelv strap |
2,559 |
2,322 |
$18K |
| A4284 |
Replcmnt breast pump shield |
1,561 |
1,182 |
$17K |
| B4150 |
Ef complet w/intact nutrient |
300 |
235 |
$17K |
| A6402 |
Sterile gauze <= 16 sq in |
2,434 |
1,904 |
$17K |
| B4152 |
Ef calorie dense>/=1.5kcal |
211 |
154 |
$17K |
| T4530 |
Ped size brief/diaper lg |
95 |
93 |
$16K |
| A4338 |
Indwelling catheter latex |
1,190 |
1,041 |
$16K |
| E0163 |
Commode chair with fixed arm |
301 |
277 |
$16K |
| L2270 |
Varus/valgus strap padded/li |
346 |
191 |
$14K |
| A4456 |
Adhesive remover, wipes |
1,170 |
1,032 |
$13K |
| K0006 |
Heavy duty wheelchair |
229 |
188 |
$12K |
| E0155 |
Walker wheel attachment,pair |
596 |
570 |
$12K |
| E0483 |
Hi freq chest wall oscil sys |
12 |
12 |
$12K |
| A4310 |
Insert tray w/o bag/cath |
1,389 |
1,221 |
$12K |
| E0303 |
Hosp bed hvy dty xtra wide |
102 |
82 |
$11K |
| L0621 |
Sio flex pelvic/sacr pre ots |
167 |
147 |
$10K |
| B4035 |
Enteral feed supp pump per d |
96 |
50 |
$9K |
| E1226 |
Manual fully reclining back |
175 |
173 |
$9K |
| K0002 |
Stnd hemi (low seat) whlchr |
217 |
178 |
$9K |
| A7036 |
Pos airway press chinstrap |
872 |
832 |
$9K |
| G0249 |
Provide inr test mater/equip |
355 |
308 |
$8K |
| E0135 |
Walker folding adjust/fixed |
173 |
169 |
$8K |
| A4231 |
Infusion insulin pump needle |
60 |
58 |
$8K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
29 |
24 |
$8K |
| E0149 |
Heavy duty wheeled walker |
218 |
171 |
$7K |
| E0159 |
Brake for wheeled walker |
445 |
313 |
$7K |
| A4450 |
Non-waterproof tape |
1,231 |
1,011 |
$7K |
| A5056 |
1 pc ost pouch w filter |
74 |
67 |
$7K |
| A7003 |
Nebulizer administration set |
3,066 |
2,851 |
$6K |
| A4281 |
Replacement breastpump tube |
826 |
759 |
$6K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
38 |
28 |
$6K |
| A4425 |
Ost pch drain for barrier fl |
79 |
75 |
$5K |
| K0903 |
Mult den insert dir carv/cam |
105 |
70 |
$5K |
| A4406 |
Pectin based ostomy paste |
230 |
210 |
$5K |
| L3206 |
Hightop w/ supp/pronator chi |
84 |
38 |
$4K |
| E0550 |
Humidif extens supple w ippb |
96 |
89 |
$4K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
51 |
51 |
$4K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
62 |
50 |
$4K |
| A6550 |
Neg pres wound ther drsg set |
17 |
12 |
$4K |
| E1038 |
Transport chair pt wt<=300lb |
314 |
300 |
$4K |
| E0184 |
Dry pressure mattress |
169 |
161 |
$3K |
| E0600 |
Suction pump portab hom modl |
58 |
51 |
$3K |
| A4371 |
Skin barrier powder per oz |
331 |
286 |
$2K |
| E0105 |
Cane adjust/fixed quad/3 pro |
71 |
65 |
$2K |
| K0040 |
Adjustable angle footplate |
46 |
25 |
$2K |
| A4282 |
Replacement breastpump adpt |
254 |
227 |
$2K |
| A4402 |
Lubricant per ounce |
241 |
205 |
$2K |
| A4595 |
Tens suppl 2 lead per month |
158 |
118 |
$2K |
| B9998 |
Enteral supp not otherwise c |
64 |
38 |
$2K |
| E1810 |
Adjust knee ext & flex dev |
15 |
12 |
$2K |
| E0849 |
Cervical pneum trac equip |
13 |
12 |
$2K |
| A4333 |
Urinary cath anchor device |
163 |
145 |
$2K |
| L8420 |
Prosthetic sock multi ply bk |
15 |
12 |
$1K |
| A4322 |
Irrigation syringe |
30 |
25 |
$1K |
| T4521 |
Adult size brief/diaper sm |
14 |
12 |
$1K |
| L3202 |
Oxford w/ supinat/pronator c |
24 |
12 |
$1K |
| B9002 |
Enter nutr inf pump any type |
12 |
12 |
$1K |
| A4367 |
Ostomy belt |
109 |
100 |
$1K |
| K0553 |
Ther cgm supply allowance |
14 |
12 |
$1K |
| S9445 |
Pt education noc individ |
14 |
14 |
$1K |
| A4556 |
Electrodes, pair |
71 |
64 |
$1K |
| A5512 |
Multi den insert direct form |
55 |
37 |
$1K |
| A6443 |
Conform band n/s w>=3"<5"/yd |
89 |
63 |
$963.70 |
| A4314 |
Cath w/drainage 2-way latex |
43 |
39 |
$928.48 |
| A4332 |
Lube sterile packet |
72 |
62 |
$864.66 |
| L3807 |
Whfo w/o joints pre cst |
12 |
12 |
$841.38 |
| A9278 |
External receiver, cgm sys |
58 |
57 |
$562.74 |
| T4542 |
Small disposable underpad |
18 |
12 |
$518.00 |
| A4245 |
Alcohol wipes per box |
90 |
80 |
$423.06 |
| E0961 |
Wheelchair brake extension |
17 |
12 |
$414.78 |
| A4216 |
Sterile water/saline, 10 ml |
14 |
12 |
$376.38 |
| A4253 |
Blood glucose/reagent strips |
27 |
25 |
$348.62 |
| A9270 |
Non-covered item or service |
706 |
635 |
$281.12 |
| E0776 |
Iv pole |
16 |
12 |
$178.60 |
| A9999 |
Dme supply or accessory, nos |
64 |
28 |
$176.63 |
| A7013 |
Disposable compressor filter |
120 |
110 |
$127.57 |
| A6260 |
Wound cleanser any type/size |
26 |
24 |
$7.56 |
| A9901 |
Delivery/set up/dispensing |
608 |
482 |
$0.00 |
| A9279 |
Monitoring feature/devicenoc |
737 |
716 |
$0.00 |
| A4388 |
Drainable pch w ex wear barr |
18 |
12 |
$0.00 |
| B4088 |
Gastro/jejuno tube, low-pro |
20 |
18 |
$0.00 |
| A7004 |
Disposable nebulizer sml vol |
13 |
13 |
$0.00 |
| E0147 |
Walker variable wheel resist |
12 |
12 |
$0.00 |
| B4160 |
Ef ped caloric dense>/=0.7kc |
14 |
13 |
$0.00 |
| A4657 |
Syringe w/wo needle |
18 |
15 |
$0.00 |
| B4161 |
Ef ped hydrolyzed/amino acid |
17 |
14 |
$0.00 |