| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
21,451 |
19,182 |
$1.71M |
| A7030 |
Cpap full face mask |
8,206 |
7,477 |
$904K |
| E0601 |
Cont airway pressure device |
12,381 |
11,105 |
$698K |
| A4351 |
Straight tip urine catheter |
2,983 |
2,344 |
$535K |
| A4604 |
Tubing with heating element |
12,303 |
11,263 |
$496K |
| E0466 |
Home vent non-invasive inter |
510 |
484 |
$391K |
| A7031 |
Replacement facemask interfa |
8,251 |
7,427 |
$386K |
| T4526 |
Adult size pull-on med |
3,784 |
3,338 |
$312K |
| A7034 |
Nasal application device |
4,260 |
3,876 |
$303K |
| T4527 |
Adult size pull-on lg |
3,461 |
3,107 |
$286K |
| E0470 |
Rad w/o backup non-inv intfc |
2,276 |
1,991 |
$281K |
| E0445 |
Oximeter non-invasive |
1,761 |
1,391 |
$280K |
| E1392 |
Portable oxygen concentrator |
7,610 |
6,811 |
$253K |
| T4528 |
Adult size pull-on xl |
2,167 |
1,915 |
$233K |
| K0738 |
Portable gas oxygen system |
6,883 |
5,961 |
$212K |
| E0562 |
Humidifier heated used w pap |
11,214 |
10,267 |
$209K |
| B4035 |
Enteral feed supp pump per d |
1,331 |
879 |
$188K |
| T4535 |
Disposable liner/shield/pad |
4,391 |
3,799 |
$185K |
| E0570 |
Nebulizer with compression |
20,210 |
18,454 |
$183K |
| A7035 |
Pos airway press headgear |
8,540 |
7,738 |
$181K |
| T4534 |
Youth size pull-on |
1,951 |
1,735 |
$165K |
| T4541 |
Large disposable underpad |
5,992 |
5,215 |
$163K |
| A7032 |
Replacement nasal cushion |
3,673 |
3,252 |
$156K |
| T4523 |
Adult size brief/diaper lg |
1,599 |
1,440 |
$135K |
| T4524 |
Adult size brief/diaper xl |
1,300 |
1,135 |
$132K |
| A7038 |
Pos airway pressure filter |
20,424 |
18,248 |
$132K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,220 |
2,523 |
$123K |
| T4522 |
Adult size brief/diaper med |
1,308 |
1,160 |
$119K |
| B4088 |
Gastro/jejuno tube, low-pro |
734 |
554 |
$77K |
| A7046 |
Repl water chamber, pap dev |
5,797 |
5,339 |
$73K |
| A4606 |
Oxygen probe used w oximeter |
789 |
603 |
$62K |
| A6530 |
Compression stocking bk18-30 |
1,843 |
683 |
$57K |
| A4927 |
Non-sterile gloves |
6,801 |
5,817 |
$53K |
| A4217 |
Sterile water/saline, 500 ml |
758 |
592 |
$51K |
| A7033 |
Replacement nasal pillows |
1,955 |
1,692 |
$49K |
| E0465 |
Home vent invasive interface |
109 |
59 |
$44K |
| B9002 |
Enter nutr inf pump any type |
658 |
574 |
$43K |
| B4161 |
Ef ped hydrolyzed/amino acid |
76 |
48 |
$43K |
| T4544 |
Adlt disp und/pull on abv xl |
415 |
389 |
$41K |
| E0431 |
Portable gaseous 02 |
2,547 |
2,127 |
$40K |
| A4385 |
Ost skn barrier sld ext wear |
716 |
514 |
$37K |
| T4533 |
Youth size brief/diaper |
320 |
267 |
$34K |
| A5063 |
Drain ostomy pouch w/flange |
993 |
738 |
$26K |
| A7039 |
Filter, non disposable w pap |
3,618 |
3,311 |
$25K |
| E0600 |
Suction pump portab hom modl |
616 |
571 |
$25K |
| A7001 |
Nondisposable pump canister |
776 |
606 |
$24K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
424 |
320 |
$24K |
| E0604 |
Hosp grade elec breast pump |
236 |
209 |
$21K |
| A7003 |
Nebulizer administration set |
5,049 |
4,387 |
$14K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
78 |
52 |
$13K |
| K0001 |
Standard wheelchair |
1,321 |
1,035 |
$13K |
| A5120 |
Skin barrier, wipe or swab |
1,739 |
1,316 |
$13K |
| A4357 |
Bedside drainage bag |
1,117 |
853 |
$11K |
| A5513 |
Multi den insert custom mold |
321 |
144 |
$10K |
| B4034 |
Enter feed supkit syr by day |
295 |
202 |
$10K |
| A5500 |
Diab shoe for density insert |
314 |
131 |
$9K |
| A4406 |
Pectin based ostomy paste |
425 |
357 |
$8K |
| A7037 |
Pos airway pressure tubing |
381 |
334 |
$7K |
| A4322 |
Irrigation syringe |
269 |
206 |
$6K |
| A4409 |
Ost skn barr convex <=4 sq i |
51 |
40 |
$5K |
| E0630 |
Patient lift hydraulic |
110 |
90 |
$5K |
| B4149 |
Ef blenderized foods |
13 |
12 |
$4K |
| S8120 |
O2 contents gas cubic ft |
122 |
79 |
$4K |
| A4402 |
Lubricant per ounce |
679 |
508 |
$4K |
| A9999 |
Dme supply or accessory, nos |
315 |
218 |
$4K |
| T4531 |
Ped size pull-on sm/med |
48 |
46 |
$4K |
| E0565 |
Compressor air power source |
99 |
82 |
$3K |
| A6212 |
Foam drg <=16 sq in w/border |
15 |
12 |
$3K |
| A7526 |
Tracheostomy tube collar |
156 |
88 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
300 |
223 |
$3K |
| A7005 |
Nondisposable nebulizer set |
172 |
152 |
$3K |
| K0195 |
Elevating whlchair leg rests |
508 |
430 |
$1K |
| A7036 |
Pos airway press chinstrap |
115 |
102 |
$1K |
| T4521 |
Adult size brief/diaper sm |
12 |
12 |
$1K |
| T4530 |
Ped size brief/diaper lg |
16 |
13 |
$1K |
| A4624 |
Tracheal suction tube |
14 |
12 |
$980.73 |
| A4628 |
Oropharyngeal suction cath |
58 |
38 |
$915.43 |
| A4371 |
Skin barrier powder per oz |
267 |
206 |
$900.59 |
| L0621 |
Sio flex pelvic/sacr pre ots |
14 |
13 |
$692.25 |
| A7015 |
Aerosol mask used w nebulize |
591 |
500 |
$680.11 |
| E0245 |
Tub stool or bench |
12 |
12 |
$632.44 |
| T4537 |
Reusable underpad bed size |
15 |
14 |
$566.20 |
| E0143 |
Walker folding wheeled w/o s |
15 |
14 |
$507.48 |
| E1130 |
Whlchr stand fxd arm ft rest |
29 |
26 |
$275.91 |
| E0305 |
Rails bed side half length |
72 |
60 |
$162.75 |
| A4450 |
Non-waterproof tape |
66 |
46 |
$130.83 |
| E0971 |
Wheelchair anti-tipping devi |
46 |
37 |
$116.67 |
| E0181 |
Press pad alternating w/ pum |
15 |
12 |
$93.57 |
| A4358 |
Urinary leg or abdomen bag |
19 |
12 |
$54.98 |
| A4616 |
Tubing (oxygen) per foot |
29 |
29 |
$0.00 |