| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
37,456 |
32,078 |
$1.81M |
| E0603 |
Electric breast pump |
3,171 |
3,100 |
$1.15M |
| E0601 |
Cont airway pressure device |
29,146 |
26,396 |
$1.10M |
| B4035 |
Enteral feed supp pump per d |
5,740 |
5,106 |
$805K |
| A7032 |
Replacement nasal cushion |
16,987 |
15,862 |
$755K |
| A7030 |
Cpap full face mask |
11,998 |
10,412 |
$743K |
| E0260 |
Hosp bed semi-electr w/ matt |
25,986 |
20,352 |
$645K |
| A4604 |
Tubing with heating element |
22,827 |
20,293 |
$624K |
| A7034 |
Nasal application device |
13,040 |
11,651 |
$606K |
| E0466 |
Home vent non-invasive inter |
1,589 |
1,374 |
$595K |
| E0570 |
Nebulizer with compression |
25,233 |
22,493 |
$539K |
| A7031 |
Replacement facemask interfa |
18,848 |
16,922 |
$510K |
| E0562 |
Humidifier heated used w pap |
4,248 |
3,770 |
$433K |
| K0001 |
Standard wheelchair |
25,432 |
20,599 |
$396K |
| E0465 |
Home vent invasive interface |
1,226 |
759 |
$327K |
| A7033 |
Replacement nasal pillows |
9,885 |
9,186 |
$315K |
| E0431 |
Portable gaseous 02 |
26,498 |
22,685 |
$247K |
| E0470 |
Rad w/o backup non-inv intfc |
4,694 |
4,108 |
$232K |
| E0277 |
Powered pres-redu air mattrs |
1,719 |
1,435 |
$222K |
| E0143 |
Walker folding wheeled w/o s |
7,372 |
6,126 |
$215K |
| B4150 |
Ef complet w/intact nutrient |
2,647 |
2,314 |
$213K |
| A7035 |
Pos airway press headgear |
15,623 |
13,844 |
$210K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,471 |
1,994 |
$209K |
| T4522 |
Adult size brief/diaper med |
4,637 |
4,039 |
$191K |
| T4527 |
Adult size pull-on lg |
3,080 |
2,558 |
$180K |
| A4624 |
Tracheal suction tube |
2,366 |
1,861 |
$178K |
| A7038 |
Pos airway pressure filter |
53,099 |
48,022 |
$169K |
| E0630 |
Patient lift hydraulic |
6,910 |
5,765 |
$168K |
| E2611 |
Gen use back cush wdth <22in |
1,976 |
1,469 |
$168K |
| B9998 |
Enteral supp not otherwise c |
5,529 |
3,819 |
$140K |
| K0007 |
Extra heavy duty wheelchair |
2,444 |
2,056 |
$139K |
| B4161 |
Ef ped hydrolyzed/amino acid |
595 |
542 |
$135K |
| E0185 |
Gel pressure mattress pad |
1,668 |
1,364 |
$131K |
| K0006 |
Heavy duty wheelchair |
2,980 |
2,525 |
$109K |
| A7046 |
Repl water chamber, pap dev |
10,739 |
9,674 |
$102K |
| T4528 |
Adult size pull-on xl |
1,551 |
1,134 |
$100K |
| K0003 |
Lightweight wheelchair |
5,771 |
4,644 |
$99K |
| E0163 |
Commode chair with fixed arm |
3,454 |
2,786 |
$91K |
| A4623 |
Tracheostomy inner cannula |
1,602 |
1,161 |
$90K |
| A7526 |
Tracheostomy tube collar |
2,375 |
1,825 |
$89K |
| A4520 |
Incontinence garment anytype |
1,567 |
1,382 |
$80K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
778 |
724 |
$78K |
| K0195 |
Elevating whlchair leg rests |
14,589 |
11,967 |
$78K |
| E0265 |
Hosp bed total electr w/ mat |
1,654 |
1,371 |
$77K |
| B4034 |
Enter feed supkit syr by day |
1,618 |
1,329 |
$76K |
| E0973 |
W/ch access det adj armrest |
2,008 |
1,027 |
$76K |
| T4524 |
Adult size brief/diaper xl |
2,332 |
1,806 |
$76K |
| T4541 |
Large disposable underpad |
3,532 |
2,774 |
$68K |
| E0303 |
Hosp bed hvy dty xtra wide |
1,176 |
1,008 |
$66K |
| T4523 |
Adult size brief/diaper lg |
1,078 |
916 |
$64K |
| E0445 |
Oximeter non-invasive |
2,283 |
2,243 |
$64K |
| E0971 |
Wheelchair anti-tipping devi |
3,131 |
1,836 |
$54K |
| B9002 |
Enter nutr inf pump any type |
1,720 |
1,474 |
$52K |
| E1392 |
Portable oxygen concentrator |
5,397 |
4,597 |
$51K |
| E0600 |
Suction pump portab hom modl |
2,814 |
2,405 |
$48K |
| A4629 |
Tracheostomy care kit |
1,217 |
918 |
$45K |
| E2601 |
Gen w/c cushion wdth < 22 in |
3,010 |
2,256 |
$44K |
| E0247 |
Trans bench w/wo comm open |
967 |
825 |
$44K |
| E0240 |
Bath/shower chair |
2,330 |
2,202 |
$42K |
| K0004 |
High strength ltwt whlchr |
1,403 |
1,244 |
$41K |
| A7039 |
Filter, non disposable w pap |
7,960 |
6,977 |
$39K |
| A7005 |
Nondisposable nebulizer set |
3,873 |
3,592 |
$37K |
| A4554 |
Disposable underpads |
2,604 |
2,269 |
$34K |
| A7037 |
Pos airway pressure tubing |
2,614 |
2,306 |
$30K |
| A4927 |
Non-sterile gloves |
4,052 |
3,190 |
$26K |
| A7507 |
Integrated filter & holder |
1,188 |
865 |
$26K |
| E0165 |
Commode chair with detacharm |
2,098 |
1,605 |
$21K |
| T4533 |
Youth size brief/diaper |
375 |
341 |
$20K |
| A4217 |
Sterile water/saline, 500 ml |
1,250 |
1,029 |
$19K |
| A4628 |
Oropharyngeal suction cath |
1,848 |
1,464 |
$18K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
153 |
131 |
$16K |
| A7000 |
Disposable canister for pump |
3,084 |
2,471 |
$16K |
| E1226 |
Manual fully reclining back |
1,070 |
963 |
$16K |
| A7520 |
Trach/laryn tube non-cuffed |
1,004 |
808 |
$16K |
| E0961 |
Wheelchair brake extension |
1,509 |
806 |
$15K |
| T4535 |
Disposable liner/shield/pad |
1,085 |
944 |
$13K |
| E0156 |
Walker seat attachment |
1,968 |
1,665 |
$13K |
| E0261 |
Hosp bed semi-electr w/o mat |
532 |
446 |
$12K |
| E1038 |
Transport chair pt wt<=300lb |
1,910 |
1,589 |
$10K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,014 |
903 |
$10K |
| A7036 |
Pos airway press chinstrap |
1,196 |
1,057 |
$10K |
| A4627 |
Spacer bag/reservoir |
989 |
961 |
$9K |
| E0565 |
Compressor air power source |
545 |
480 |
$9K |
| E0149 |
Heavy duty wheeled walker |
488 |
446 |
$9K |
| E0471 |
Rad w/backup non inv intrfc |
115 |
104 |
$8K |
| E0776 |
Iv pole |
1,935 |
1,579 |
$8K |
| A7002 |
Tubing used w suction pump |
3,111 |
2,421 |
$8K |
| A4606 |
Oxygen probe used w oximeter |
460 |
420 |
$7K |
| E0951 |
Loop heel |
984 |
505 |
$7K |
| E0181 |
Press pad alternating w/ pum |
1,167 |
1,001 |
$6K |
| E0244 |
Toilet seat raised |
241 |
223 |
$5K |
| T4521 |
Adult size brief/diaper sm |
56 |
51 |
$5K |
| E0271 |
Mattress innerspring |
373 |
350 |
$4K |
| K0738 |
Portable gas oxygen system |
559 |
434 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
2,326 |
2,083 |
$2K |
| E0978 |
W/c acc,saf belt pelv strap |
162 |
127 |
$2K |
| A7010 |
Disposable corrugated tubing |
108 |
83 |
$2K |
| A4322 |
Irrigation syringe |
64 |
55 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
497 |
357 |
$1K |
| A7013 |
Disposable compressor filter |
4,167 |
3,871 |
$1K |
| E0910 |
Trapeze bar attached to bed |
186 |
172 |
$1K |
| E0100 |
Cane adjust/fixed with tip |
40 |
40 |
$772.82 |
| E0105 |
Cane adjust/fixed quad/3 pro |
29 |
28 |
$719.61 |
| A7007 |
Lg vol nebulizer disposable |
82 |
67 |
$351.40 |
| E0118 |
Crutch substitute |
110 |
108 |
$263.29 |
| B4155 |
Ef incomplete/modular |
15 |
12 |
$232.11 |
| A7045 |
Repl exhalation port for pap |
16 |
13 |
$225.57 |
| E0912 |
Hd trapeze bar free standing |
12 |
12 |
$223.67 |
| E1020 |
Residual limb support system |
28 |
26 |
$222.78 |
| A7003 |
Nebulizer administration set |
647 |
615 |
$147.74 |
| A7012 |
Nebulizer water collec devic |
32 |
26 |
$120.68 |
| E0184 |
Dry pressure mattress |
79 |
71 |
$119.44 |
| A7525 |
Tracheostomy mask |
31 |
24 |
$18.33 |
| E0305 |
Rails bed side half length |
104 |
91 |
$8.99 |
| A4216 |
Sterile water/saline, 10 ml |
72 |
50 |
$0.00 |