| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
14,417 |
13,759 |
$688K |
| K0108 |
W/c component-accessory nos |
1,725 |
760 |
$342K |
| A4624 |
Tracheal suction tube |
1,092 |
904 |
$203K |
| E1161 |
Manual adult wc w tiltinspac |
1,693 |
1,061 |
$189K |
| E0431 |
Portable gaseous 02 |
13,966 |
13,327 |
$185K |
| E1399 |
Durable medical equipment mi |
201 |
133 |
$161K |
| E1028 |
W/c manual swingaway |
2,778 |
1,840 |
$138K |
| K0001 |
Standard wheelchair |
7,980 |
7,437 |
$116K |
| A7520 |
Trach/laryn tube non-cuffed |
1,124 |
819 |
$108K |
| B4035 |
Enteral feed supp pump per d |
1,062 |
797 |
$95K |
| A7526 |
Tracheostomy tube collar |
1,303 |
1,133 |
$85K |
| A4629 |
Tracheostomy care kit |
763 |
654 |
$69K |
| K0823 |
Pwc gp 2 std cap chair |
1,048 |
936 |
$61K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,067 |
874 |
$60K |
| E0443 |
Portable 02 contents, gas |
1,324 |
1,089 |
$58K |
| E0955 |
Cushioned headrest |
1,267 |
1,003 |
$56K |
| E0445 |
Oximeter non-invasive |
540 |
513 |
$55K |
| E0973 |
W/ch access det adj armrest |
734 |
442 |
$53K |
| A7507 |
Integrated filter & holder |
1,115 |
772 |
$53K |
| E0630 |
Patient lift hydraulic |
2,247 |
2,081 |
$52K |
| B4034 |
Enter feed supkit syr by day |
1,448 |
1,284 |
$50K |
| E0143 |
Walker folding wheeled w/o s |
1,773 |
1,623 |
$47K |
| K0195 |
Elevating whlchair leg rests |
5,633 |
5,185 |
$46K |
| E0277 |
Powered pres-redu air mattrs |
567 |
495 |
$45K |
| S8120 |
O2 contents gas cubic ft |
899 |
499 |
$41K |
| E0600 |
Suction pump portab hom modl |
1,057 |
1,014 |
$38K |
| A4623 |
Tracheostomy inner cannula |
317 |
277 |
$36K |
| E0250 |
Hosp bed fixed ht w/ mattres |
3,113 |
2,917 |
$30K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,468 |
1,266 |
$29K |
| K0040 |
Adjustable angle footplate |
454 |
294 |
$29K |
| E0971 |
Wheelchair anti-tipping devi |
1,966 |
1,260 |
$27K |
| A7030 |
Cpap full face mask |
386 |
365 |
$27K |
| E0260 |
Hosp bed semi-electr w/ matt |
290 |
275 |
$27K |
| K0006 |
Heavy duty wheelchair |
690 |
627 |
$23K |
| K0003 |
Lightweight wheelchair |
834 |
781 |
$22K |
| E0261 |
Hosp bed semi-electr w/o mat |
217 |
213 |
$19K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
286 |
239 |
$19K |
| E0251 |
Hosp bed fixd ht w/o mattres |
2,194 |
2,040 |
$18K |
| E0978 |
W/c acc,saf belt pelv strap |
1,143 |
854 |
$17K |
| E0570 |
Nebulizer with compression |
1,792 |
1,731 |
$17K |
| K0007 |
Extra heavy duty wheelchair |
308 |
267 |
$17K |
| A7000 |
Disposable canister for pump |
1,432 |
1,091 |
$17K |
| A4927 |
Non-sterile gloves |
1,159 |
982 |
$17K |
| A7032 |
Replacement nasal cushion |
1,056 |
1,002 |
$16K |
| A4604 |
Tubing with heating element |
627 |
595 |
$15K |
| E0601 |
Cont airway pressure device |
460 |
436 |
$14K |
| E2601 |
Gen w/c cushion wdth < 22 in |
674 |
599 |
$13K |
| A7002 |
Tubing used w suction pump |
1,325 |
1,117 |
$12K |
| B9002 |
Enter nutr inf pump any type |
260 |
246 |
$12K |
| E0163 |
Commode chair with fixed arm |
453 |
407 |
$11K |
| E1226 |
Manual fully reclining back |
241 |
221 |
$11K |
| A7034 |
Nasal application device |
237 |
226 |
$10K |
| A4628 |
Oropharyngeal suction cath |
770 |
670 |
$10K |
| A4606 |
Oxygen probe used w oximeter |
279 |
88 |
$8K |
| A4218 |
Sterile saline or water |
112 |
108 |
$8K |
| A6402 |
Sterile gauze <= 16 sq in |
573 |
503 |
$7K |
| E2607 |
Skin pro/pos wc cus wd <22in |
45 |
30 |
$7K |
| E0565 |
Compressor air power source |
197 |
188 |
$7K |
| A7038 |
Pos airway pressure filter |
1,765 |
1,672 |
$6K |
| K0825 |
Pwc gp 2 hd cap chair |
63 |
60 |
$5K |
| A7007 |
Lg vol nebulizer disposable |
871 |
547 |
$4K |
| E0562 |
Humidifier heated used w pap |
209 |
202 |
$4K |
| E2620 |
Wc planar back cush wd <22in |
21 |
12 |
$4K |
| A7525 |
Tracheostomy mask |
1,111 |
795 |
$4K |
| A7003 |
Nebulizer administration set |
1,471 |
999 |
$3K |
| A7046 |
Repl water chamber, pap dev |
363 |
348 |
$3K |
| B4154 |
Ef spec metabolic noninherit |
64 |
50 |
$3K |
| E2361 |
22nf sealed leadacid battery |
14 |
12 |
$3K |
| E0303 |
Hosp bed hvy dty xtra wide |
50 |
48 |
$3K |
| A7035 |
Pos airway press headgear |
207 |
196 |
$2K |
| E0149 |
Heavy duty wheeled walker |
105 |
103 |
$2K |
| E0961 |
Wheelchair brake extension |
127 |
83 |
$2K |
| A7039 |
Filter, non disposable w pap |
426 |
410 |
$2K |
| E0165 |
Commode chair with detacharm |
98 |
87 |
$1K |
| E0184 |
Dry pressure mattress |
15 |
13 |
$1K |
| E2231 |
Solid seat support base |
18 |
12 |
$1K |
| B9998 |
Enteral supp not otherwise c |
16 |
12 |
$1K |
| B4088 |
Gastro/jejuno tube, low-pro |
40 |
38 |
$1K |
| E1035 |
Patient transfer system <300 |
45 |
37 |
$799.41 |
| A7012 |
Nebulizer water collec devic |
264 |
166 |
$782.40 |
| E0960 |
W/c shoulder harness/straps |
14 |
12 |
$752.60 |
| E2611 |
Gen use back cush wdth <22in |
14 |
12 |
$705.60 |
| E0951 |
Loop heel |
36 |
24 |
$550.99 |
| K0072 |
Fr cstr semi-pne tire rep ea |
17 |
13 |
$487.78 |
| A7010 |
Disposable corrugated tubing |
28 |
25 |
$230.92 |
| K0002 |
Stnd hemi (low seat) whlchr |
12 |
12 |
$94.39 |
| A4245 |
Alcohol wipes per box |
12 |
12 |
$29.62 |