| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
29,031 |
20,980 |
$1.68M |
| E0465 |
Home vent invasive interface |
1,420 |
822 |
$480K |
| B4035 |
Enteral feed supp pump per d |
5,230 |
2,502 |
$448K |
| A4554 |
Disposable underpads |
6,440 |
5,815 |
$333K |
| K0738 |
Portable gas oxygen system |
13,329 |
11,251 |
$284K |
| E0445 |
Oximeter non-invasive |
1,665 |
1,456 |
$249K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,046 |
590 |
$248K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,439 |
1,956 |
$246K |
| T4527 |
Adult size pull-on lg |
1,750 |
1,609 |
$244K |
| S5165 |
Home modifications per serv |
357 |
232 |
$238K |
| T4526 |
Adult size pull-on med |
1,761 |
1,608 |
$228K |
| E0601 |
Cont airway pressure device |
5,053 |
4,241 |
$226K |
| E0260 |
Hosp bed semi-electr w/ matt |
7,437 |
5,627 |
$203K |
| B4150 |
Ef complet w/intact nutrient |
3,103 |
1,952 |
$198K |
| E2402 |
Neg press wound therapy pump |
482 |
369 |
$180K |
| E0466 |
Home vent non-invasive inter |
604 |
388 |
$164K |
| T4528 |
Adult size pull-on xl |
1,068 |
950 |
$151K |
| K0003 |
Lightweight wheelchair |
5,556 |
4,657 |
$147K |
| A7030 |
Cpap full face mask |
2,047 |
1,818 |
$145K |
| B4154 |
Ef spec metabolic noninherit |
1,798 |
1,202 |
$141K |
| B4034 |
Enter feed supkit syr by day |
3,142 |
1,589 |
$139K |
| T4544 |
Adlt disp und/pull on abv xl |
603 |
545 |
$131K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,891 |
1,051 |
$129K |
| E0143 |
Walker folding wheeled w/o s |
2,765 |
2,435 |
$119K |
| T4534 |
Youth size pull-on |
723 |
684 |
$103K |
| T4522 |
Adult size brief/diaper med |
743 |
671 |
$92K |
| E0562 |
Humidifier heated used w pap |
743 |
682 |
$90K |
| K0823 |
Pwc gp 2 std cap chair |
723 |
487 |
$89K |
| E0470 |
Rad w/o backup non-inv intfc |
1,020 |
768 |
$78K |
| A4629 |
Tracheostomy care kit |
1,548 |
1,045 |
$74K |
| B9002 |
Enter nutr inf pump any type |
1,246 |
967 |
$73K |
| E0163 |
Commode chair with fixed arm |
1,751 |
1,589 |
$71K |
| A4623 |
Tracheostomy inner cannula |
1,282 |
815 |
$70K |
| E0277 |
Powered pres-redu air mattrs |
426 |
264 |
$68K |
| E0570 |
Nebulizer with compression |
3,122 |
3,003 |
$62K |
| A4624 |
Tracheal suction tube |
971 |
621 |
$61K |
| E0247 |
Trans bench w/wo comm open |
730 |
651 |
$57K |
| T4535 |
Disposable liner/shield/pad |
1,460 |
900 |
$55K |
| K0007 |
Extra heavy duty wheelchair |
963 |
703 |
$53K |
| T4523 |
Adult size brief/diaper lg |
381 |
347 |
$49K |
| T4524 |
Adult size brief/diaper xl |
367 |
325 |
$47K |
| E0971 |
Wheelchair anti-tipping devi |
1,353 |
1,183 |
$46K |
| K0001 |
Standard wheelchair |
2,980 |
2,571 |
$45K |
| A7034 |
Nasal application device |
1,113 |
974 |
$45K |
| K0195 |
Elevating whlchair leg rests |
5,467 |
5,126 |
$44K |
| E1392 |
Portable oxygen concentrator |
2,205 |
1,841 |
$43K |
| E0303 |
Hosp bed hvy dty xtra wide |
514 |
371 |
$42K |
| T4525 |
Adult size pull-on sm |
362 |
328 |
$40K |
| E0630 |
Patient lift hydraulic |
1,894 |
1,368 |
$40K |
| A7035 |
Pos airway press headgear |
2,637 |
2,332 |
$40K |
| E0240 |
Bath/shower chair |
702 |
642 |
$39K |
| A7031 |
Replacement facemask interfa |
1,715 |
1,407 |
$37K |
| A7037 |
Pos airway pressure tubing |
1,490 |
1,331 |
$33K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,089 |
997 |
$27K |
| L8501 |
Tracheostomy speaking valve |
374 |
289 |
$27K |
| B4155 |
Ef incomplete/modular |
554 |
312 |
$26K |
| E0600 |
Suction pump portab hom modl |
1,107 |
934 |
$26K |
| K0006 |
Heavy duty wheelchair |
870 |
646 |
$26K |
| A6550 |
Neg pres wound ther drsg set |
236 |
128 |
$24K |
| E0431 |
Portable gaseous 02 |
1,369 |
1,195 |
$24K |
| A7520 |
Trach/laryn tube non-cuffed |
828 |
618 |
$23K |
| E1028 |
W/c manual swingaway |
576 |
399 |
$23K |
| E0961 |
Wheelchair brake extension |
1,124 |
990 |
$23K |
| B4088 |
Gastro/jejuno tube, low-pro |
228 |
211 |
$22K |
| E0149 |
Heavy duty wheeled walker |
722 |
638 |
$21K |
| B9998 |
Enteral supp not otherwise c |
2,444 |
1,085 |
$20K |
| A7526 |
Tracheostomy tube collar |
1,523 |
1,039 |
$20K |
| A7000 |
Disposable canister for pump |
1,587 |
1,172 |
$20K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
1,083 |
770 |
$14K |
| E0165 |
Commode chair with detacharm |
624 |
571 |
$13K |
| T4521 |
Adult size brief/diaper sm |
94 |
85 |
$11K |
| E2611 |
Gen use back cush wdth <22in |
94 |
88 |
$10K |
| A7032 |
Replacement nasal cushion |
573 |
455 |
$9K |
| E0156 |
Walker seat attachment |
1,029 |
909 |
$9K |
| A4604 |
Tubing with heating element |
1,574 |
1,358 |
$9K |
| E0912 |
Hd trapeze bar free standing |
288 |
205 |
$9K |
| E0565 |
Compressor air power source |
298 |
245 |
$8K |
| E0185 |
Gel pressure mattress pad |
117 |
97 |
$8K |
| A7038 |
Pos airway pressure filter |
3,552 |
2,873 |
$7K |
| B9004 |
Parenteral infus pump portab |
40 |
40 |
$7K |
| T4543 |
Adult disp brief/diap abv xl |
36 |
24 |
$6K |
| K0002 |
Stnd hemi (low seat) whlchr |
268 |
226 |
$5K |
| E0471 |
Rad w/backup non inv intrfc |
14 |
12 |
$4K |
| A7521 |
Trach/laryn tube cuffed |
309 |
183 |
$4K |
| E0181 |
Press pad alternating w/ pum |
467 |
426 |
$4K |
| A7033 |
Replacement nasal pillows |
309 |
244 |
$3K |
| A7002 |
Tubing used w suction pump |
1,327 |
936 |
$3K |
| A4628 |
Oropharyngeal suction cath |
863 |
669 |
$3K |
| E0910 |
Trapeze bar attached to bed |
437 |
417 |
$3K |
| A7003 |
Nebulizer administration set |
1,627 |
1,435 |
$2K |
| E0114 |
Crutch underarm pair no wood |
56 |
51 |
$2K |
| E0776 |
Iv pole |
43 |
38 |
$2K |
| A7046 |
Repl water chamber, pap dev |
860 |
719 |
$1K |
| E2202 |
Seat width 24-27 in |
164 |
108 |
$1K |
| E0168 |
Heavyduty/wide commode chair |
17 |
12 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
871 |
787 |
$985.79 |
| A7012 |
Nebulizer water collec devic |
422 |
298 |
$979.66 |
| E0973 |
W/ch access det adj armrest |
21 |
13 |
$883.36 |
| T2025 |
Waiver service, nos |
20 |
12 |
$738.67 |
| E1020 |
Residual limb support system |
13 |
13 |
$700.76 |
| E1038 |
Transport chair pt wt<=300lb |
157 |
136 |
$674.02 |
| E1399 |
Durable medical equipment mi |
44 |
40 |
$530.97 |
| A7525 |
Tracheostomy mask |
1,117 |
665 |
$421.08 |
| A7013 |
Disposable compressor filter |
819 |
773 |
$374.35 |