| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
224,659 |
220,202 |
$20.19M |
| B4161 |
Ef ped hydrolyzed/amino acid |
5,274 |
4,787 |
$6.08M |
| B4035 |
Enteral feed supp pump per d |
19,266 |
16,250 |
$3.59M |
| E0465 |
Home vent invasive interface |
3,895 |
2,522 |
$3.43M |
| A7030 |
Cpap full face mask |
33,906 |
33,387 |
$3.36M |
| E0431 |
Portable gaseous 02 |
185,696 |
176,174 |
$3.12M |
| E0601 |
Cont airway pressure device |
51,960 |
51,432 |
$2.91M |
| E0603 |
Electric breast pump |
19,171 |
18,811 |
$2.41M |
| E0424 |
Stationary compressed gas 02 |
21,629 |
21,118 |
$2.36M |
| E0470 |
Rad w/o backup non-inv intfc |
18,386 |
18,137 |
$2.23M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,981 |
6,364 |
$1.93M |
| A7031 |
Replacement facemask interfa |
33,614 |
33,109 |
$1.89M |
| T4541 |
Large disposable underpad |
16,346 |
15,755 |
$1.69M |
| T4523 |
Adult size brief/diaper lg |
10,891 |
10,527 |
$1.57M |
| E0466 |
Home vent non-invasive inter |
1,546 |
1,216 |
$1.44M |
| T4527 |
Adult size pull-on lg |
10,534 |
10,365 |
$1.44M |
| E1399 |
Durable medical equipment mi |
5,207 |
4,442 |
$1.38M |
| T4522 |
Adult size brief/diaper med |
12,999 |
12,670 |
$1.37M |
| A4353 |
Intermittent urinary cath |
1,499 |
1,448 |
$1.33M |
| K0108 |
W/c component-accessory nos |
8,888 |
2,440 |
$1.31M |
| T4526 |
Adult size pull-on med |
9,914 |
9,754 |
$1.25M |
| E0471 |
Rad w/backup non inv intrfc |
4,578 |
4,509 |
$1.19M |
| E0445 |
Oximeter non-invasive |
7,876 |
7,485 |
$1.17M |
| A4604 |
Tubing with heating element |
29,995 |
29,637 |
$1.16M |
| E0570 |
Nebulizer with compression |
45,728 |
45,257 |
$1.11M |
| B4149 |
Ef blenderized foods |
3,048 |
2,687 |
$1.03M |
| T4524 |
Adult size brief/diaper xl |
6,694 |
6,497 |
$1.03M |
| E0562 |
Humidifier heated used w pap |
18,645 |
18,414 |
$1.01M |
| A4351 |
Straight tip urine catheter |
4,772 |
4,541 |
$940K |
| K0001 |
Standard wheelchair |
40,015 |
39,313 |
$922K |
| B9998 |
Enteral supp not otherwise c |
9,063 |
8,016 |
$899K |
| T4534 |
Youth size pull-on |
6,512 |
6,362 |
$856K |
| B9002 |
Enter nutr inf pump any type |
10,560 |
10,332 |
$852K |
| B4153 |
Ef hydrolyzed/amino acids |
1,473 |
1,340 |
$833K |
| T4528 |
Adult size pull-on xl |
4,647 |
4,570 |
$750K |
| B4150 |
Ef complet w/intact nutrient |
5,643 |
5,040 |
$687K |
| A7034 |
Nasal application device |
10,862 |
10,677 |
$667K |
| K0003 |
Lightweight wheelchair |
16,178 |
15,915 |
$646K |
| B4088 |
Gastro/jejuno tube, low-pro |
3,881 |
3,721 |
$614K |
| A7038 |
Pos airway pressure filter |
64,395 |
63,360 |
$563K |
| A7032 |
Replacement nasal cushion |
9,056 |
8,865 |
$562K |
| A7035 |
Pos airway press headgear |
27,836 |
27,292 |
$533K |
| E1392 |
Portable oxygen concentrator |
17,002 |
16,859 |
$520K |
| E0260 |
Hosp bed semi-electr w/ matt |
11,380 |
11,132 |
$515K |
| T4530 |
Ped size brief/diaper lg |
5,248 |
5,126 |
$510K |
| T4543 |
Adult disp brief/diap abv xl |
2,363 |
2,318 |
$455K |
| B4155 |
Ef incomplete/modular |
3,689 |
3,111 |
$435K |
| E0143 |
Walker folding wheeled w/o s |
8,975 |
8,792 |
$402K |
| A4605 |
Trach suction cath close sys |
1,031 |
931 |
$384K |
| B4158 |
Ef ped complete intact nut |
1,516 |
1,398 |
$379K |
| E0277 |
Powered pres-redu air mattrs |
1,531 |
1,491 |
$355K |
| E0439 |
Stationary liquid 02 |
3,819 |
3,338 |
$353K |
| T4533 |
Youth size brief/diaper |
2,822 |
2,748 |
$341K |
| A4217 |
Sterile water/saline, 500 ml |
3,277 |
2,828 |
$336K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,418 |
2,217 |
$320K |
| T4529 |
Ped size brief/diaper sm/med |
3,218 |
3,118 |
$315K |
| E0118 |
Crutch substitute |
4,249 |
4,064 |
$301K |
| T4521 |
Adult size brief/diaper sm |
2,899 |
2,807 |
$296K |
| A7526 |
Tracheostomy tube collar |
3,766 |
3,450 |
$279K |
| T4525 |
Adult size pull-on sm |
2,055 |
1,984 |
$262K |
| A4409 |
Ost skn barr convex <=4 sq i |
3,175 |
3,012 |
$260K |
| E0202 |
Phototherapy light w/ photom |
5,637 |
1,217 |
$259K |
| E0700 |
Safety equipment |
3,190 |
3,175 |
$255K |
| A7037 |
Pos airway pressure tubing |
13,843 |
13,694 |
$251K |
| A9901 |
Delivery/set up/dispensing |
49,109 |
45,092 |
$247K |
| A7046 |
Repl water chamber, pap dev |
20,496 |
20,214 |
$245K |
| E1028 |
W/c manual swingaway |
2,096 |
1,205 |
$227K |
| B4154 |
Ef spec metabolic noninherit |
1,175 |
1,091 |
$222K |
| E0604 |
Hosp grade elec breast pump |
3,142 |
3,108 |
$218K |
| A6212 |
Foam drg <=16 sq in w/border |
943 |
826 |
$217K |
| A4385 |
Ost skn barrier sld ext wear |
2,711 |
2,583 |
$212K |
| A4483 |
Moisture exchanger |
1,709 |
1,465 |
$205K |
| A4624 |
Tracheal suction tube |
3,371 |
2,778 |
$201K |
| A9900 |
Supply/accessory/service |
4,643 |
2,916 |
$196K |
| A4927 |
Non-sterile gloves |
18,858 |
17,624 |
$191K |
| T4535 |
Disposable liner/shield/pad |
3,191 |
3,138 |
$184K |
| A7033 |
Replacement nasal pillows |
3,713 |
3,658 |
$179K |
| E0600 |
Suction pump portab hom modl |
5,932 |
5,787 |
$172K |
| A4425 |
Ost pch drain for barrier fl |
3,483 |
3,348 |
$165K |
| E0434 |
Portable liquid 02 |
7,470 |
7,115 |
$163K |
| A7520 |
Trach/laryn tube non-cuffed |
3,081 |
2,770 |
$160K |
| A4452 |
Waterproof tape |
6,437 |
6,102 |
$156K |
| A4629 |
Tracheostomy care kit |
2,508 |
2,067 |
$141K |
| E0630 |
Patient lift hydraulic |
3,337 |
3,276 |
$136K |
| K0195 |
Elevating whlchair leg rests |
12,480 |
12,240 |
$135K |
| K0007 |
Extra heavy duty wheelchair |
1,392 |
1,365 |
$133K |
| E0240 |
Bath/shower chair |
2,407 |
2,391 |
$132K |
| A4424 |
Ost pch drain w bar & filter |
1,581 |
1,535 |
$126K |
| B4087 |
Gastro/jejuno tube, std |
2,910 |
2,800 |
$119K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,563 |
1,510 |
$113K |
| A4322 |
Irrigation syringe |
5,573 |
4,920 |
$112K |
| A4407 |
Ext wear ost skn barr <=4sq" |
982 |
918 |
$104K |
| A4520 |
Incontinence garment anytype |
1,748 |
1,702 |
$102K |
| A7000 |
Disposable canister for pump |
5,603 |
5,284 |
$100K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
1,335 |
1,254 |
$97K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
603 |
565 |
$90K |
| T4544 |
Adlt disp und/pull on abv xl |
381 |
375 |
$86K |
| A6402 |
Sterile gauze <= 16 sq in |
9,481 |
8,653 |
$85K |
| E0776 |
Iv pole |
6,928 |
6,758 |
$84K |
| A4606 |
Oxygen probe used w oximeter |
1,548 |
1,416 |
$84K |
| A4649 |
Surgical supplies |
826 |
723 |
$84K |
| A4670 |
Automatic bp monitor, dial |
1,850 |
1,824 |
$80K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
519 |
440 |
$80K |
| A4618 |
Breathing circuits |
2,022 |
1,735 |
$74K |
| K0823 |
Pwc gp 2 std cap chair |
70 |
69 |
$71K |
| T4532 |
Ped size pull-on lg |
413 |
407 |
$66K |
| E0973 |
W/ch access det adj armrest |
952 |
670 |
$64K |
| A6266 |
Impreg gauze no h20/sal/yard |
637 |
572 |
$62K |
| E0482 |
Cough stimulating device |
200 |
198 |
$61K |
| E0955 |
Cushioned headrest |
550 |
532 |
$59K |
| E0265 |
Hosp bed total electr w/ mat |
715 |
710 |
$52K |
| E1236 |
Folding ped wc adjustable |
76 |
75 |
$51K |
| E0163 |
Commode chair with fixed arm |
940 |
932 |
$50K |
| A7008 |
Disposable nebulizer prefill |
407 |
360 |
$48K |
| A5063 |
Drain ostomy pouch w/flange |
1,180 |
1,152 |
$47K |
| A4556 |
Electrodes, pair |
874 |
802 |
$46K |
| E0443 |
Portable 02 contents, gas |
1,434 |
1,381 |
$44K |
| E0971 |
Wheelchair anti-tipping devi |
1,794 |
1,718 |
$44K |
| A4628 |
Oropharyngeal suction cath |
3,845 |
3,435 |
$42K |
| A4406 |
Pectin based ostomy paste |
2,779 |
2,688 |
$39K |
| E0247 |
Trans bench w/wo comm open |
892 |
885 |
$39K |
| B4034 |
Enter feed supkit syr by day |
496 |
452 |
$39K |
| A4357 |
Bedside drainage bag |
3,215 |
3,046 |
$38K |
| A4369 |
Skin barrier liquid per oz |
2,208 |
2,080 |
$38K |
| A4362 |
Solid skin barrier |
602 |
578 |
$37K |
| A4349 |
Disposable male external cat |
900 |
867 |
$37K |
| E2607 |
Skin pro/pos wc cus wd <22in |
172 |
168 |
$36K |
| A6260 |
Wound cleanser any type/size |
1,663 |
1,539 |
$36K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
302 |
297 |
$36K |
| A4394 |
Ostomy pouch liq deodorant |
1,597 |
1,502 |
$32K |
| A4554 |
Disposable underpads |
958 |
933 |
$32K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,149 |
1,121 |
$31K |
| E0978 |
W/c acc,saf belt pelv strap |
2,173 |
2,121 |
$29K |
| E0156 |
Walker seat attachment |
2,889 |
2,826 |
$29K |
| A5120 |
Skin barrier, wipe or swab |
4,076 |
3,835 |
$29K |
| K0006 |
Heavy duty wheelchair |
606 |
595 |
$28K |
| K0040 |
Adjustable angle footplate |
315 |
293 |
$26K |
| A4456 |
Adhesive remover, wipes |
2,100 |
2,056 |
$24K |
| E0565 |
Compressor air power source |
746 |
707 |
$24K |
| E0149 |
Heavy duty wheeled walker |
304 |
298 |
$23K |
| B4100 |
Food thickener oral |
677 |
664 |
$23K |
| E0181 |
Press pad alternating w/ pum |
2,126 |
2,096 |
$23K |
| E0730 |
Tens four lead |
99 |
99 |
$21K |
| A7509 |
Heat & moisture exchange sys |
380 |
360 |
$18K |
| A6197 |
Alginate drsg >16 <=48 sq in |
55 |
53 |
$16K |
| A7036 |
Pos airway press chinstrap |
1,650 |
1,630 |
$16K |
| A4358 |
Urinary leg or abdomen bag |
1,853 |
1,764 |
$16K |
| E0990 |
Wheelchair elevating leg res |
1,337 |
1,299 |
$15K |
| A7004 |
Disposable nebulizer sml vol |
10,883 |
10,588 |
$14K |
| A4213 |
20+ cc syringe only |
2,063 |
1,928 |
$14K |
| A4595 |
Tens suppl 2 lead per month |
477 |
438 |
$14K |
| A4332 |
Lube sterile packet |
1,594 |
1,522 |
$14K |
| E0185 |
Gel pressure mattress pad |
777 |
757 |
$14K |
| E1225 |
Manual semi-reclining back |
256 |
249 |
$14K |
| E1038 |
Transport chair pt wt<=300lb |
1,879 |
1,849 |
$14K |
| E0159 |
Brake for wheeled walker |
1,678 |
1,645 |
$13K |
| A7002 |
Tubing used w suction pump |
1,885 |
1,758 |
$12K |
| A4335 |
Incontinence supply |
695 |
683 |
$12K |
| A4310 |
Insert tray w/o bag/cath |
447 |
430 |
$12K |
| E0241 |
Bath tub wall rail |
545 |
501 |
$12K |
| A4371 |
Skin barrier powder per oz |
2,747 |
2,678 |
$12K |
| E0100 |
Cane adjust/fixed with tip |
851 |
846 |
$12K |
| E0245 |
Tub stool or bench |
280 |
275 |
$11K |
| E2374 |
Hand/chin ctrl std joystick |
32 |
28 |
$11K |
| A6446 |
Conform band s w>=3" <5"/yd |
320 |
294 |
$11K |
| E0303 |
Hosp bed hvy dty xtra wide |
96 |
95 |
$10K |
| A4344 |
Cath indw foley 2 way silicn |
349 |
332 |
$10K |
| A4338 |
Indwelling catheter latex |
701 |
658 |
$10K |
| A4216 |
Sterile water/saline, 10 ml |
942 |
854 |
$10K |
| B4104 |
Additive for enteral formula |
103 |
98 |
$10K |
| A7039 |
Filter, non disposable w pap |
1,401 |
1,365 |
$9K |
| A6258 |
Transparent film >16<=48 in |
75 |
64 |
$9K |
| A4450 |
Non-waterproof tape |
1,352 |
1,299 |
$9K |
| A7015 |
Aerosol mask used w nebulize |
5,480 |
5,281 |
$8K |
| A7003 |
Nebulizer administration set |
3,881 |
3,774 |
$8K |
| E0956 |
W/c lateral trunk/hip suppor |
83 |
51 |
$8K |
| E0960 |
W/c shoulder harness/straps |
91 |
90 |
$8K |
| A7525 |
Tracheostomy mask |
1,338 |
1,230 |
$6K |
| A4402 |
Lubricant per ounce |
924 |
893 |
$6K |
| K0002 |
Stnd hemi (low seat) whlchr |
210 |
210 |
$6K |
| A4455 |
Adhesive remover per ounce |
1,979 |
1,912 |
$6K |
| B4036 |
Enteral feed sup kit grav by |
71 |
65 |
$6K |
| A5056 |
1 pc ost pouch w filter |
108 |
101 |
$5K |
| A6216 |
Non-sterile gauze<=16 sq in |
727 |
687 |
$5K |
| A4627 |
Spacer bag/reservoir |
360 |
358 |
$5K |
| E0244 |
Toilet seat raised |
79 |
78 |
$4K |
| E2361 |
22nf sealed leadacid battery |
30 |
27 |
$4K |
| A6250 |
Skin seal protect moisturizr |
29 |
27 |
$4K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
73 |
65 |
$4K |
| E0310 |
Rails bed side full length |
464 |
462 |
$3K |
| A5061 |
Pouch drainable w barrier at |
39 |
36 |
$3K |
| A4623 |
Tracheostomy inner cannula |
60 |
55 |
$2K |
| A7045 |
Repl exhalation port for pap |
107 |
99 |
$2K |
| K0738 |
Portable gas oxygen system |
76 |
74 |
$2K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
25 |
24 |
$2K |
| E0444 |
Portable 02 contents, liquid |
37 |
37 |
$2K |
| L3908 |
Who cock-up nonmolde pre ots |
38 |
25 |
$2K |
| E1355 |
Oxygen supplies stand/rack |
100 |
96 |
$2K |
| A6242 |
Hydrogel drg <=16 in w/o bdr |
15 |
14 |
$2K |
| E0910 |
Trapeze bar attached to bed |
214 |
210 |
$2K |
| E0105 |
Cane adjust/fixed quad/3 pro |
48 |
48 |
$1K |
| E0114 |
Crutch underarm pair no wood |
41 |
40 |
$1K |
| A7521 |
Trach/laryn tube cuffed |
27 |
25 |
$1K |
| A4419 |
Ost pch for bar w flange/flt |
13 |
12 |
$988.22 |
| A4367 |
Ostomy belt |
133 |
133 |
$985.95 |
| E1372 |
Oxy suppl heater for nebuliz |
104 |
101 |
$741.51 |
| A6240 |
Hydrocolld drg filler paste |
12 |
12 |
$526.97 |
| A7012 |
Nebulizer water collec devic |
108 |
101 |
$515.28 |
| A4364 |
Adhesive, liquid or equal |
86 |
85 |
$455.79 |
| A6443 |
Conform band n/s w>=3"<5"/yd |
29 |
28 |
$448.20 |
| E0243 |
Toilet rail |
12 |
12 |
$392.78 |
| E0705 |
Transfer device |
12 |
12 |
$357.96 |
| A4245 |
Alcohol wipes per box |
55 |
52 |
$127.05 |
| A4657 |
Syringe w/wo needle |
12 |
12 |
$11.43 |
| A9286 |
Any hygienic item, device |
43 |
42 |
$2.67 |
| A4616 |
Tubing (oxygen) per foot |
15 |
15 |
$0.72 |