| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
6,092 |
5,630 |
$3.67M |
| K0108 |
W/c component-accessory nos |
21,551 |
8,528 |
$2.97M |
| E1399 |
Durable medical equipment mi |
2,623 |
2,152 |
$1.80M |
| E0465 |
Home vent invasive interface |
3,030 |
1,958 |
$1.76M |
| T2029 |
Special med equip, noswaiver |
6,374 |
5,188 |
$1.43M |
| K0739 |
Repair/svc dme non-oxygen eq |
19,402 |
16,793 |
$942K |
| E0240 |
Bath/shower chair |
430 |
394 |
$906K |
| T4541 |
Large disposable underpad |
12,351 |
11,964 |
$569K |
| A4351 |
Straight tip urine catheter |
2,786 |
2,575 |
$524K |
| A4353 |
Intermittent urinary cath |
390 |
370 |
$483K |
| E1028 |
W/c manual swingaway |
5,068 |
3,480 |
$473K |
| E1161 |
Manual adult wc w tiltinspac |
1,708 |
1,670 |
$463K |
| T4522 |
Adult size brief/diaper med |
2,553 |
2,461 |
$396K |
| A9999 |
Dme supply or accessory, nos |
3,914 |
1,788 |
$339K |
| T4526 |
Adult size pull-on med |
2,861 |
2,802 |
$327K |
| T4527 |
Adult size pull-on lg |
2,354 |
2,275 |
$284K |
| T4523 |
Adult size brief/diaper lg |
1,587 |
1,520 |
$278K |
| A4927 |
Non-sterile gloves |
9,695 |
9,265 |
$275K |
| B4035 |
Enteral feed supp pump per d |
1,260 |
1,073 |
$262K |
| T4534 |
Youth size pull-on |
1,956 |
1,852 |
$247K |
| E2311 |
Electro connect btw 2 sys |
139 |
131 |
$237K |
| T4535 |
Disposable liner/shield/pad |
2,709 |
2,606 |
$230K |
| A4624 |
Tracheal suction tube |
1,243 |
1,116 |
$227K |
| T4528 |
Adult size pull-on xl |
1,538 |
1,476 |
$213K |
| T4533 |
Youth size brief/diaper |
1,063 |
1,041 |
$199K |
| A4629 |
Tracheostomy care kit |
1,959 |
1,839 |
$142K |
| E0973 |
W/ch access det adj armrest |
1,226 |
1,045 |
$140K |
| E2363 |
Gr24 sealed leadacid battery |
525 |
483 |
$119K |
| E0955 |
Cushioned headrest |
1,773 |
1,697 |
$117K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,731 |
2,531 |
$112K |
| B4150 |
Ef complet w/intact nutrient |
643 |
539 |
$106K |
| K0040 |
Adjustable angle footplate |
1,107 |
958 |
$102K |
| K0823 |
Pwc gp 2 std cap chair |
311 |
306 |
$93K |
| A4606 |
Oxygen probe used w oximeter |
464 |
400 |
$80K |
| B4152 |
Ef calorie dense>/=1.5kcal |
308 |
271 |
$79K |
| T4524 |
Adult size brief/diaper xl |
446 |
424 |
$78K |
| E1390 |
Oxygen concentrator |
1,344 |
1,308 |
$78K |
| A4217 |
Sterile water/saline, 500 ml |
1,400 |
1,222 |
$76K |
| E0630 |
Patient lift hydraulic |
1,346 |
1,306 |
$72K |
| E2300 |
Pwr seat elevation sys |
33 |
25 |
$70K |
| K0005 |
Ultralightweight wheelchair |
41 |
39 |
$69K |
| T4525 |
Adult size pull-on sm |
553 |
531 |
$68K |
| A4605 |
Trach suction cath close sys |
248 |
233 |
$67K |
| E2607 |
Skin pro/pos wc cus wd <22in |
319 |
304 |
$65K |
| B9998 |
Enteral supp not otherwise c |
1,276 |
943 |
$62K |
| E0971 |
Wheelchair anti-tipping devi |
1,167 |
982 |
$60K |
| E1012 |
Ctr mount pwr elev leg rest |
52 |
49 |
$50K |
| T4521 |
Adult size brief/diaper sm |
348 |
332 |
$45K |
| A7521 |
Trach/laryn tube cuffed |
1,092 |
925 |
$45K |
| T4543 |
Adult disp brief/diap abv xl |
152 |
147 |
$44K |
| A7526 |
Tracheostomy tube collar |
827 |
780 |
$43K |
| E0445 |
Oximeter non-invasive |
177 |
166 |
$42K |
| A4349 |
Disposable male external cat |
532 |
487 |
$42K |
| A4357 |
Bedside drainage bag |
2,148 |
1,981 |
$40K |
| E0978 |
W/c acc,saf belt pelv strap |
1,249 |
1,185 |
$33K |
| A4623 |
Tracheostomy inner cannula |
177 |
164 |
$29K |
| E2213 |
Pneumatic prop tire insert |
618 |
538 |
$28K |
| E2377 |
Expandable controller, initl |
83 |
77 |
$28K |
| E0601 |
Cont airway pressure device |
647 |
630 |
$27K |
| E0600 |
Suction pump portab hom modl |
792 |
766 |
$23K |
| E2620 |
Wc planar back cush wd <22in |
57 |
57 |
$22K |
| E2313 |
Pwc harness, expand control |
81 |
77 |
$22K |
| E0986 |
Man w/c powr assist syst |
13 |
12 |
$22K |
| E0261 |
Hosp bed semi-electr w/o mat |
510 |
481 |
$21K |
| A7000 |
Disposable canister for pump |
1,472 |
1,399 |
$19K |
| E0960 |
W/c shoulder harness/straps |
237 |
226 |
$19K |
| E2298 |
Pwr seat elev sys for crt |
12 |
12 |
$18K |
| K0001 |
Standard wheelchair |
701 |
686 |
$17K |
| A4604 |
Tubing with heating element |
369 |
364 |
$15K |
| K0738 |
Portable gas oxygen system |
594 |
580 |
$15K |
| E0277 |
Powered pres-redu air mattrs |
54 |
53 |
$14K |
| A4358 |
Urinary leg or abdomen bag |
1,084 |
1,005 |
$14K |
| A4483 |
Moisture exchanger |
128 |
105 |
$13K |
| E0961 |
Wheelchair brake extension |
417 |
329 |
$13K |
| E0562 |
Humidifier heated used w pap |
881 |
863 |
$13K |
| E2611 |
Gen use back cush wdth <22in |
85 |
84 |
$12K |
| A4216 |
Sterile water/saline, 10 ml |
672 |
630 |
$12K |
| E1392 |
Portable oxygen concentrator |
445 |
435 |
$12K |
| A4310 |
Insert tray w/o bag/cath |
366 |
341 |
$10K |
| K0003 |
Lightweight wheelchair |
196 |
196 |
$10K |
| A7002 |
Tubing used w suction pump |
1,523 |
1,371 |
$10K |
| E2386 |
Foam filled drive wheel tire |
62 |
43 |
$9K |
| A7031 |
Replacement facemask interfa |
202 |
193 |
$8K |
| B9002 |
Enter nutr inf pump any type |
96 |
85 |
$8K |
| A4402 |
Lubricant per ounce |
737 |
716 |
$8K |
| E2231 |
Solid seat support base |
69 |
68 |
$7K |
| A4628 |
Oropharyngeal suction cath |
757 |
675 |
$7K |
| A4332 |
Lube sterile packet |
364 |
341 |
$7K |
| B4088 |
Gastro/jejuno tube, low-pro |
178 |
147 |
$7K |
| A7030 |
Cpap full face mask |
70 |
69 |
$7K |
| E0953 |
W/c lateral thigh/knee sup |
38 |
36 |
$5K |
| A7035 |
Pos airway press headgear |
227 |
220 |
$5K |
| A4245 |
Alcohol wipes per box |
958 |
923 |
$5K |
| E0951 |
Loop heel |
234 |
192 |
$4K |
| E2211 |
Pneumatic propulsion tire |
68 |
64 |
$4K |
| A7038 |
Pos airway pressure filter |
906 |
880 |
$4K |
| E0550 |
Humidif extens supple w ippb |
117 |
113 |
$4K |
| A7032 |
Replacement nasal cushion |
87 |
85 |
$3K |
| E2366 |
Battery charger, single mode |
25 |
24 |
$3K |
| E0570 |
Nebulizer with compression |
335 |
332 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
225 |
202 |
$3K |
| E2601 |
Gen w/c cushion wdth < 22 in |
86 |
85 |
$3K |
| E2394 |
Drive wheel excludes tire |
37 |
28 |
$3K |
| E0956 |
W/c lateral trunk/hip suppor |
16 |
14 |
$2K |
| S8189 |
Trach supply noc |
128 |
104 |
$2K |
| A7034 |
Nasal application device |
37 |
37 |
$2K |
| K0019 |
Arm pad repl, each |
121 |
98 |
$2K |
| K0195 |
Elevating whlchair leg rests |
191 |
191 |
$2K |
| A7520 |
Trach/laryn tube non-cuffed |
28 |
24 |
$2K |
| A4338 |
Indwelling catheter latex |
57 |
54 |
$2K |
| A7003 |
Nebulizer administration set |
520 |
473 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
25 |
25 |
$1K |
| T1013 |
Sign lang/oral interpreter |
21 |
13 |
$900.90 |
| K0002 |
Stnd hemi (low seat) whlchr |
26 |
26 |
$804.16 |
| A7046 |
Repl water chamber, pap dev |
52 |
49 |
$710.44 |
| E2210 |
Wheelchair bearings |
39 |
37 |
$501.83 |
| A4244 |
Alcohol or peroxide per pint |
174 |
168 |
$279.83 |
| A4657 |
Syringe w/wo needle |
12 |
12 |
$9.80 |