| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
502 |
301 |
$384K |
| E0601 |
Cont airway pressure device |
8,773 |
8,507 |
$353K |
| T2029 |
Special med equip, noswaiver |
2,557 |
2,216 |
$336K |
| T4527 |
Adult size pull-on lg |
2,841 |
2,760 |
$279K |
| T4528 |
Adult size pull-on xl |
2,160 |
2,097 |
$243K |
| T4535 |
Disposable liner/shield/pad |
3,978 |
3,726 |
$234K |
| E1390 |
Oxygen concentrator |
3,968 |
3,821 |
$226K |
| A4604 |
Tubing with heating element |
5,677 |
5,581 |
$209K |
| T4526 |
Adult size pull-on med |
2,149 |
2,059 |
$201K |
| A7030 |
Cpap full face mask |
2,193 |
2,156 |
$186K |
| A7034 |
Nasal application device |
2,808 |
2,748 |
$150K |
| L4361 |
Pneuma/vac walk boot pre ots |
616 |
588 |
$121K |
| E0562 |
Humidifier heated used w pap |
826 |
808 |
$112K |
| E0603 |
Electric breast pump |
709 |
691 |
$91K |
| A7035 |
Pos airway press headgear |
4,498 |
4,410 |
$86K |
| T4541 |
Large disposable underpad |
2,042 |
1,942 |
$82K |
| T4544 |
Adlt disp und/pull on abv xl |
343 |
326 |
$61K |
| T4523 |
Adult size brief/diaper lg |
359 |
342 |
$59K |
| T4534 |
Youth size pull-on |
463 |
418 |
$54K |
| A7031 |
Replacement facemask interfa |
1,609 |
1,578 |
$53K |
| E0570 |
Nebulizer with compression |
2,237 |
2,187 |
$53K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,023 |
1,005 |
$52K |
| L1833 |
Ko adj jnt pos r sup pre ots |
288 |
271 |
$45K |
| K0001 |
Standard wheelchair |
2,350 |
2,313 |
$44K |
| K0738 |
Portable gas oxygen system |
1,526 |
1,497 |
$40K |
| T4522 |
Adult size brief/diaper med |
276 |
260 |
$39K |
| A7038 |
Pos airway pressure filter |
7,949 |
7,767 |
$36K |
| E1392 |
Portable oxygen concentrator |
1,149 |
1,115 |
$33K |
| L3908 |
Who cock-up nonmolde pre ots |
601 |
525 |
$32K |
| A7032 |
Replacement nasal cushion |
1,076 |
1,049 |
$31K |
| E0470 |
Rad w/o backup non-inv intfc |
268 |
265 |
$27K |
| A7046 |
Repl water chamber, pap dev |
2,090 |
2,050 |
$24K |
| E0118 |
Crutch substitute |
640 |
623 |
$22K |
| E0143 |
Walker folding wheeled w/o s |
424 |
412 |
$21K |
| A4927 |
Non-sterile gloves |
764 |
700 |
$20K |
| L3809 |
Whfo w/o joints pre ots |
239 |
227 |
$20K |
| E0114 |
Crutch underarm pair no wood |
574 |
562 |
$19K |
| A4351 |
Straight tip urine catheter |
122 |
112 |
$19K |
| T4525 |
Adult size pull-on sm |
169 |
165 |
$16K |
| L1902 |
Afo ankle gauntlet pre ots |
246 |
235 |
$15K |
| A7033 |
Replacement nasal pillows |
663 |
648 |
$15K |
| B4150 |
Ef complet w/intact nutrient |
208 |
134 |
$12K |
| K0108 |
W/c component-accessory nos |
173 |
73 |
$10K |
| A4385 |
Ost skn barrier sld ext wear |
166 |
154 |
$10K |
| T4524 |
Adult size brief/diaper xl |
59 |
57 |
$9K |
| K0739 |
Repair/svc dme non-oxygen eq |
179 |
161 |
$7K |
| A6530 |
Compression stocking bk18-30 |
116 |
110 |
$7K |
| K0003 |
Lightweight wheelchair |
110 |
106 |
$4K |
| L3040 |
Ft arch suprt premold longit |
87 |
82 |
$4K |
| A4627 |
Spacer bag/reservoir |
114 |
109 |
$3K |
| A4670 |
Automatic bp monitor, dial |
37 |
37 |
$3K |
| A7039 |
Filter, non disposable w pap |
345 |
340 |
$2K |
| E1399 |
Durable medical equipment mi |
18 |
13 |
$2K |
| A7003 |
Nebulizer administration set |
914 |
882 |
$2K |
| A4520 |
Incontinence garment anytype |
62 |
54 |
$2K |
| E0245 |
Tub stool or bench |
26 |
26 |
$2K |
| A4357 |
Bedside drainage bag |
72 |
66 |
$2K |
| E0156 |
Walker seat attachment |
76 |
75 |
$1K |
| B9998 |
Enteral supp not otherwise c |
21 |
12 |
$1K |
| K0195 |
Elevating whlchair leg rests |
75 |
74 |
$852.09 |
| L1812 |
Ko elastic w/joints pre ots |
14 |
12 |
$811.93 |
| B4035 |
Enteral feed supp pump per d |
14 |
12 |
$682.45 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
13 |
12 |
$656.85 |
| E0250 |
Hosp bed fixed ht w/ mattres |
28 |
28 |
$494.22 |
| A7037 |
Pos airway pressure tubing |
43 |
41 |
$461.71 |
| A7013 |
Disposable compressor filter |
75 |
73 |
$61.93 |
| A7015 |
Aerosol mask used w nebulize |
16 |
15 |
$24.65 |