| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
64,806 |
43,644 |
$2.99M |
| E0465 |
Home vent invasive interface |
3,564 |
2,057 |
$1.96M |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,651 |
1,260 |
$1.47M |
| E1399 |
Durable medical equipment mi |
7,451 |
2,638 |
$1.07M |
| B4035 |
Enteral feed supp pump per d |
6,310 |
4,456 |
$1.07M |
| B9998 |
Enteral supp not otherwise c |
13,964 |
6,729 |
$1.02M |
| E0601 |
Cont airway pressure device |
27,423 |
20,940 |
$851K |
| B4149 |
Ef blenderized foods |
2,323 |
1,750 |
$846K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
3,326 |
2,500 |
$737K |
| B4036 |
Enteral feed sup kit grav by |
8,187 |
5,410 |
$569K |
| A7030 |
Cpap full face mask |
10,980 |
7,799 |
$524K |
| B4152 |
Ef calorie dense>/=1.5kcal |
4,792 |
2,646 |
$497K |
| B4150 |
Ef complet w/intact nutrient |
4,395 |
2,600 |
$405K |
| A4604 |
Tubing with heating element |
16,603 |
11,896 |
$332K |
| E0570 |
Nebulizer with compression |
22,721 |
15,692 |
$327K |
| A7031 |
Replacement facemask interfa |
12,497 |
8,818 |
$284K |
| E0445 |
Oximeter non-invasive |
1,984 |
1,550 |
$271K |
| E0431 |
Portable gaseous 02 |
31,057 |
21,584 |
$262K |
| E0470 |
Rad w/o backup non-inv intfc |
5,222 |
3,711 |
$256K |
| B4154 |
Ef spec metabolic noninherit |
844 |
434 |
$245K |
| E0562 |
Humidifier heated used w pap |
14,919 |
11,888 |
$236K |
| E1093 |
Wheelchair wide w/ foot rest |
2,533 |
2,208 |
$231K |
| E0203 |
Therapeutic lightbox tabletp |
2,882 |
2,411 |
$212K |
| A7034 |
Nasal application device |
6,742 |
4,896 |
$210K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,479 |
2,749 |
$208K |
| E1086 |
Hemi-wheelchair detachable a |
2,477 |
2,213 |
$205K |
| A7507 |
Integrated filter & holder |
4,866 |
2,911 |
$202K |
| K0823 |
Pwc gp 2 std cap chair |
424 |
237 |
$201K |
| B9002 |
Enter nutr inf pump any type |
3,271 |
2,566 |
$200K |
| E1028 |
W/c manual swingaway |
1,574 |
778 |
$200K |
| A4624 |
Tracheal suction tube |
2,459 |
1,777 |
$185K |
| A4351 |
Straight tip urine catheter |
2,056 |
1,571 |
$180K |
| A7526 |
Tracheostomy tube collar |
3,912 |
2,770 |
$172K |
| E0973 |
W/ch access det adj armrest |
4,516 |
2,013 |
$161K |
| A4606 |
Oxygen probe used w oximeter |
4,445 |
2,496 |
$155K |
| A4605 |
Trach suction cath close sys |
2,030 |
1,344 |
$152K |
| A6530 |
Compression stocking bk18-30 |
3,074 |
1,856 |
$148K |
| A4623 |
Tracheostomy inner cannula |
1,915 |
1,283 |
$148K |
| A7035 |
Pos airway press headgear |
14,799 |
10,595 |
$147K |
| E0600 |
Suction pump portab hom modl |
4,115 |
2,891 |
$135K |
| A7032 |
Replacement nasal cushion |
5,124 |
3,850 |
$128K |
| A6402 |
Sterile gauze <= 16 sq in |
7,916 |
5,681 |
$128K |
| E1392 |
Portable oxygen concentrator |
9,698 |
6,779 |
$127K |
| A7046 |
Repl water chamber, pap dev |
11,484 |
8,053 |
$125K |
| A4649 |
Surgical supplies |
7,038 |
4,258 |
$122K |
| E1140 |
Wheelchair standard detach a |
3,058 |
2,696 |
$121K |
| E0143 |
Walker folding wheeled w/o s |
4,672 |
3,183 |
$111K |
| A4629 |
Tracheostomy care kit |
1,860 |
1,324 |
$98K |
| E2611 |
Gen use back cush wdth <22in |
1,342 |
785 |
$91K |
| K0738 |
Portable gas oxygen system |
8,587 |
6,016 |
$90K |
| A7520 |
Trach/laryn tube non-cuffed |
2,386 |
1,591 |
$89K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,441 |
863 |
$89K |
| K0739 |
Repair/svc dme non-oxygen eq |
4,113 |
2,285 |
$87K |
| B4153 |
Ef hydrolyzed/amino acids |
219 |
157 |
$80K |
| A7002 |
Tubing used w suction pump |
5,613 |
3,911 |
$80K |
| A7038 |
Pos airway pressure filter |
24,843 |
18,085 |
$75K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
1,056 |
702 |
$71K |
| A7005 |
Nondisposable nebulizer set |
6,760 |
5,070 |
$66K |
| A7037 |
Pos airway pressure tubing |
6,131 |
4,325 |
$63K |
| A6549 |
Grad com garm noc day use |
692 |
226 |
$60K |
| A7033 |
Replacement nasal pillows |
2,811 |
2,076 |
$56K |
| K0800 |
Pov group 1 std up to 300lbs |
168 |
90 |
$51K |
| E0603 |
Electric breast pump |
207 |
174 |
$50K |
| L3908 |
Who cock-up nonmolde pre ots |
1,061 |
766 |
$50K |
| A4618 |
Breathing circuits |
3,262 |
2,152 |
$46K |
| B9004 |
Parenteral infus pump portab |
203 |
149 |
$44K |
| A7000 |
Disposable canister for pump |
5,199 |
3,704 |
$43K |
| A7039 |
Filter, non disposable w pap |
11,829 |
8,371 |
$41K |
| B4034 |
Enter feed supkit syr by day |
1,200 |
913 |
$40K |
| E0245 |
Tub stool or bench |
1,195 |
951 |
$32K |
| A4409 |
Ost skn barr convex <=4 sq i |
509 |
376 |
$32K |
| L4361 |
Pneuma/vac walk boot pre ots |
216 |
169 |
$32K |
| A4670 |
Automatic bp monitor, dial |
705 |
631 |
$31K |
| E0434 |
Portable liquid 02 |
2,698 |
1,750 |
$29K |
| E0630 |
Patient lift hydraulic |
752 |
445 |
$24K |
| A7521 |
Trach/laryn tube cuffed |
820 |
508 |
$24K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,293 |
753 |
$23K |
| E0184 |
Dry pressure mattress |
1,685 |
1,047 |
$20K |
| E0961 |
Wheelchair brake extension |
2,525 |
1,097 |
$19K |
| A4385 |
Ost skn barrier sld ext wear |
364 |
264 |
$17K |
| E0443 |
Portable 02 contents, gas |
2,149 |
1,579 |
$16K |
| E0550 |
Humidif extens supple w ippb |
893 |
617 |
$16K |
| E0951 |
Loop heel |
2,530 |
1,141 |
$16K |
| A4452 |
Waterproof tape |
564 |
418 |
$16K |
| L0621 |
Sio flex pelvic/sacr pre ots |
274 |
221 |
$13K |
| A6196 |
Alginate dressing <=16 sq in |
47 |
38 |
$11K |
| A5500 |
Diab shoe for density insert |
325 |
187 |
$11K |
| E0776 |
Iv pole |
1,847 |
1,184 |
$11K |
| T4534 |
Youth size pull-on |
124 |
88 |
$11K |
| E0114 |
Crutch underarm pair no wood |
347 |
299 |
$10K |
| A7003 |
Nebulizer administration set |
7,272 |
5,165 |
$9K |
| A4927 |
Non-sterile gloves |
756 |
621 |
$9K |
| A4628 |
Oropharyngeal suction cath |
2,171 |
1,591 |
$9K |
| A6197 |
Alginate drsg >16 <=48 sq in |
17 |
13 |
$9K |
| E0149 |
Heavy duty wheeled walker |
233 |
155 |
$9K |
| E0424 |
Stationary compressed gas 02 |
41 |
37 |
$9K |
| E2365 |
U1 sealed leadacid battery |
85 |
43 |
$7K |
| E1092 |
Wheelchair wide w/ leg rests |
111 |
105 |
$7K |
| E0156 |
Walker seat attachment |
1,276 |
821 |
$6K |
| A6021 |
Collagen dressing <=16 sq in |
14 |
12 |
$6K |
| E1084 |
Hemi-wheelchair detachable a |
93 |
87 |
$6K |
| A5063 |
Drain ostomy pouch w/flange |
177 |
129 |
$5K |
| E0181 |
Press pad alternating w/ pum |
243 |
154 |
$5K |
| A4595 |
Tens suppl 2 lead per month |
238 |
148 |
$5K |
| E0635 |
Patient lift electric |
68 |
39 |
$5K |
| A6212 |
Foam drg <=16 sq in w/border |
52 |
38 |
$5K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
54 |
38 |
$4K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
12 |
12 |
$4K |
| E0627 |
Seat lift mech, electric any |
23 |
15 |
$4K |
| E0971 |
Wheelchair anti-tipping devi |
118 |
71 |
$4K |
| A5512 |
Multi den insert direct form |
99 |
56 |
$4K |
| A7015 |
Aerosol mask used w nebulize |
4,513 |
3,363 |
$3K |
| L4360 |
Pneumat walking boot pre cst |
18 |
18 |
$3K |
| K0001 |
Standard wheelchair |
3,439 |
2,647 |
$3K |
| A6446 |
Conform band s w>=3" <5"/yd |
107 |
63 |
$3K |
| A4357 |
Bedside drainage bag |
878 |
598 |
$3K |
| E0163 |
Commode chair with fixed arm |
130 |
90 |
$3K |
| A7525 |
Tracheostomy mask |
1,521 |
996 |
$3K |
| K0040 |
Adjustable angle footplate |
46 |
24 |
$3K |
| A4450 |
Non-waterproof tape |
916 |
705 |
$3K |
| A5120 |
Skin barrier, wipe or swab |
439 |
284 |
$3K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
28 |
13 |
$2K |
| B4155 |
Ef incomplete/modular |
146 |
98 |
$2K |
| A5514 |
Mult den insert dir carv/cam |
25 |
12 |
$2K |
| L8501 |
Tracheostomy speaking valve |
60 |
36 |
$2K |
| T4526 |
Adult size pull-on med |
16 |
12 |
$2K |
| E0730 |
Tens four lead |
77 |
60 |
$2K |
| E0990 |
Wheelchair elevating leg res |
214 |
117 |
$1K |
| L1812 |
Ko elastic w/joints pre ots |
32 |
25 |
$1K |
| E0244 |
Toilet seat raised |
26 |
25 |
$1K |
| A4425 |
Ost pch drain for barrier fl |
20 |
13 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
393 |
260 |
$946.97 |
| E0978 |
W/c acc,saf belt pelv strap |
56 |
37 |
$886.52 |
| L8000 |
Mastectomy bra |
19 |
13 |
$709.40 |
| A4322 |
Irrigation syringe |
208 |
129 |
$709.26 |
| A4456 |
Adhesive remover, wipes |
122 |
85 |
$688.25 |
| E0994 |
Wheelchair arm rest |
30 |
27 |
$600.72 |
| A4467 |
Belt strap sleev grmnt cover |
46 |
25 |
$584.91 |
| E0100 |
Cane adjust/fixed with tip |
60 |
55 |
$583.95 |
| A4406 |
Pectin based ostomy paste |
58 |
40 |
$553.00 |
| A7014 |
Compressor nondispos filter |
279 |
215 |
$503.36 |
| E0165 |
Commode chair with detacharm |
19 |
12 |
$368.62 |
| A4338 |
Indwelling catheter latex |
115 |
64 |
$304.24 |
| A4244 |
Alcohol or peroxide per pint |
119 |
100 |
$264.90 |
| E0621 |
Patient lift sling or seat |
26 |
13 |
$247.24 |
| K0002 |
Stnd hemi (low seat) whlchr |
2,561 |
2,003 |
$237.70 |
| K0195 |
Elevating whlchair leg rests |
1,693 |
1,275 |
$192.30 |
| K0006 |
Heavy duty wheelchair |
530 |
438 |
$120.14 |
| K0007 |
Extra heavy duty wheelchair |
175 |
141 |
$119.25 |
| A4402 |
Lubricant per ounce |
12 |
12 |
$110.62 |
| A7007 |
Lg vol nebulizer disposable |
16 |
12 |
$82.69 |
| E0305 |
Rails bed side half length |
50 |
29 |
$61.43 |
| A4332 |
Lube sterile packet |
13 |
12 |
$55.98 |
| A4245 |
Alcohol wipes per box |
14 |
12 |
$22.08 |
| A4371 |
Skin barrier powder per oz |
19 |
12 |
$13.34 |
| K0052 |
Swingaway detach ftrest repl |
44 |
20 |
$0.00 |
| K0462 |
Temporary replacement eqpmnt |
521 |
485 |
$0.00 |
| E0444 |
Portable 02 contents, liquid |
132 |
111 |
$0.00 |