| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
217,410 |
209,204 |
$19.62M |
| E0465 |
Home vent invasive interface |
5,560 |
4,290 |
$5.07M |
| A7030 |
Cpap full face mask |
42,429 |
41,196 |
$4.29M |
| E0601 |
Cont airway pressure device |
61,910 |
60,260 |
$3.95M |
| E0466 |
Home vent non-invasive inter |
4,707 |
4,309 |
$2.46M |
| A4604 |
Tubing with heating element |
65,728 |
64,119 |
$2.27M |
| A7034 |
Nasal application device |
34,356 |
33,526 |
$2.25M |
| E0260 |
Hosp bed semi-electr w/ matt |
33,879 |
32,743 |
$1.83M |
| E0603 |
Electric breast pump |
9,546 |
9,253 |
$1.81M |
| A7031 |
Replacement facemask interfa |
41,503 |
40,154 |
$1.75M |
| E0570 |
Nebulizer with compression |
48,948 |
47,239 |
$1.74M |
| E0562 |
Humidifier heated used w pap |
10,088 |
9,763 |
$1.71M |
| A7035 |
Pos airway press headgear |
67,376 |
65,759 |
$1.49M |
| E0470 |
Rad w/o backup non-inv intfc |
13,416 |
13,054 |
$1.47M |
| K0738 |
Portable gas oxygen system |
59,715 |
57,848 |
$1.24M |
| A4606 |
Oxygen probe used w oximeter |
8,002 |
7,283 |
$1.21M |
| T4527 |
Adult size pull-on lg |
11,621 |
10,906 |
$1.20M |
| T4534 |
Youth size pull-on |
7,264 |
6,943 |
$1.08M |
| A7032 |
Replacement nasal cushion |
20,274 |
19,603 |
$1.01M |
| K0001 |
Standard wheelchair |
39,154 |
37,807 |
$979K |
| T4526 |
Adult size pull-on med |
10,198 |
9,672 |
$923K |
| E0431 |
Portable gaseous 02 |
50,835 |
49,048 |
$871K |
| T4528 |
Adult size pull-on xl |
8,407 |
7,956 |
$870K |
| T4535 |
Disposable liner/shield/pad |
15,492 |
14,473 |
$845K |
| A4624 |
Tracheal suction tube |
4,872 |
4,352 |
$844K |
| T4544 |
Adlt disp und/pull on abv xl |
3,365 |
3,213 |
$646K |
| E1392 |
Portable oxygen concentrator |
49,056 |
47,602 |
$614K |
| E0143 |
Walker folding wheeled w/o s |
11,200 |
10,790 |
$579K |
| T4541 |
Large disposable underpad |
22,413 |
21,462 |
$506K |
| A7038 |
Pos airway pressure filter |
85,015 |
82,389 |
$473K |
| T4540 |
Reusable underpad chair size |
11,599 |
11,185 |
$459K |
| A4927 |
Non-sterile gloves |
27,701 |
25,121 |
$453K |
| E0482 |
Cough stimulating device |
1,504 |
1,438 |
$452K |
| A7046 |
Repl water chamber, pap dev |
41,512 |
40,387 |
$444K |
| A4623 |
Tracheostomy inner cannula |
2,777 |
2,500 |
$439K |
| A7033 |
Replacement nasal pillows |
12,469 |
12,131 |
$433K |
| L4361 |
Pneuma/vac walk boot pre ots |
2,465 |
2,357 |
$400K |
| E0471 |
Rad w/backup non inv intrfc |
1,309 |
1,263 |
$354K |
| E0114 |
Crutch underarm pair no wood |
12,039 |
11,673 |
$346K |
| T4522 |
Adult size brief/diaper med |
2,713 |
2,585 |
$317K |
| A4351 |
Straight tip urine catheter |
1,865 |
1,732 |
$316K |
| E0303 |
Hosp bed hvy dty xtra wide |
2,499 |
2,353 |
$308K |
| K0007 |
Extra heavy duty wheelchair |
3,510 |
3,397 |
$297K |
| T4523 |
Adult size brief/diaper lg |
2,395 |
2,277 |
$278K |
| A7005 |
Nondisposable nebulizer set |
16,123 |
15,335 |
$274K |
| T4530 |
Ped size brief/diaper lg |
2,022 |
1,945 |
$260K |
| T4524 |
Adult size brief/diaper xl |
2,322 |
2,203 |
$258K |
| E0265 |
Hosp bed total electr w/ mat |
1,535 |
1,500 |
$241K |
| T4543 |
Adult disp brief/diap abv xl |
1,227 |
1,154 |
$235K |
| E0445 |
Oximeter non-invasive |
6,636 |
6,388 |
$234K |
| E1399 |
Durable medical equipment mi |
1,622 |
1,339 |
$227K |
| A7508 |
Housing & integrated adhesiv |
2,088 |
1,861 |
$224K |
| A7526 |
Tracheostomy tube collar |
5,217 |
4,820 |
$216K |
| E0600 |
Suction pump portab hom modl |
6,719 |
6,386 |
$214K |
| T4525 |
Adult size pull-on sm |
1,999 |
1,906 |
$195K |
| E0163 |
Commode chair with fixed arm |
4,372 |
4,110 |
$182K |
| A7039 |
Filter, non disposable w pap |
18,833 |
18,347 |
$180K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
549 |
503 |
$179K |
| K0006 |
Heavy duty wheelchair |
3,367 |
3,250 |
$171K |
| A4629 |
Tracheostomy care kit |
3,101 |
2,831 |
$167K |
| A4353 |
Intermittent urinary cath |
306 |
257 |
$161K |
| L3809 |
Whfo w/o joints pre ots |
1,199 |
1,153 |
$156K |
| E0277 |
Powered pres-redu air mattrs |
1,943 |
1,882 |
$145K |
| E0630 |
Patient lift hydraulic |
5,761 |
5,575 |
$141K |
| A7520 |
Trach/laryn tube non-cuffed |
3,379 |
3,073 |
$140K |
| A6530 |
Compression stocking bk18-30 |
2,855 |
1,378 |
$136K |
| L3908 |
Who cock-up nonmolde pre ots |
3,282 |
2,971 |
$133K |
| L4350 |
Ankle control ortho pre ots |
2,822 |
2,714 |
$132K |
| A7037 |
Pos airway pressure tubing |
6,172 |
5,993 |
$124K |
| A4216 |
Sterile water/saline, 10 ml |
3,681 |
3,412 |
$123K |
| A6197 |
Alginate drsg >16 <=48 sq in |
612 |
507 |
$122K |
| E0240 |
Bath/shower chair |
3,493 |
3,229 |
$122K |
| A4385 |
Ost skn barrier sld ext wear |
1,573 |
1,478 |
$111K |
| E0550 |
Humidif extens supple w ippb |
2,797 |
2,653 |
$105K |
| A6212 |
Foam drg <=16 sq in w/border |
766 |
688 |
$105K |
| A4409 |
Ost skn barr convex <=4 sq i |
1,276 |
1,201 |
$101K |
| K0004 |
High strength ltwt whlchr |
1,422 |
1,366 |
$97K |
| E0149 |
Heavy duty wheeled walker |
2,171 |
2,069 |
$97K |
| E0565 |
Compressor air power source |
2,161 |
2,072 |
$95K |
| W0137 |
|
3,483 |
3,348 |
$92K |
| A4407 |
Ext wear ost skn barr <=4sq" |
752 |
697 |
$83K |
| T4521 |
Adult size brief/diaper sm |
716 |
675 |
$81K |
| E0248 |
Hdtrans bench w/wo comm open |
549 |
496 |
$79K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
1,119 |
983 |
$77K |
| A4605 |
Trach suction cath close sys |
415 |
364 |
$75K |
| A7000 |
Disposable canister for pump |
7,224 |
6,680 |
$75K |
| T4532 |
Ped size pull-on lg |
677 |
645 |
$74K |
| K0462 |
Temporary replacement eqpmnt |
977 |
915 |
$71K |
| L1830 |
Ko immob canvas long pre ots |
1,415 |
1,344 |
$70K |
| E0247 |
Trans bench w/wo comm open |
827 |
798 |
$66K |
| A6402 |
Sterile gauze <= 16 sq in |
7,179 |
6,413 |
$63K |
| A7020 |
Interface, cough stim device |
2,015 |
1,899 |
$62K |
| A4335 |
Incontinence supply |
3,705 |
3,129 |
$57K |
| A4627 |
Spacer bag/reservoir |
3,549 |
3,443 |
$55K |
| A4670 |
Automatic bp monitor, dial |
975 |
955 |
$54K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
521 |
450 |
$50K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
326 |
287 |
$48K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
657 |
616 |
$46K |
| L0641 |
Lo rig pos pnl l1-l5 pre ots |
907 |
864 |
$46K |
| A4425 |
Ost pch drain for barrier fl |
861 |
795 |
$41K |
| A7036 |
Pos airway press chinstrap |
3,654 |
3,589 |
$39K |
| L8501 |
Tracheostomy speaking valve |
626 |
586 |
$39K |
| E0168 |
Heavyduty/wide commode chair |
793 |
742 |
$38K |
| A4452 |
Waterproof tape |
2,093 |
2,039 |
$38K |
| E0165 |
Commode chair with detacharm |
3,640 |
3,473 |
$38K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,342 |
1,304 |
$37K |
| T4537 |
Reusable underpad bed size |
1,029 |
949 |
$37K |
| E0156 |
Walker seat attachment |
3,842 |
3,676 |
$36K |
| L1902 |
Afo ankle gauntlet pre ots |
728 |
688 |
$36K |
| E0971 |
Wheelchair anti-tipping devi |
7,574 |
5,808 |
$34K |
| E1038 |
Transport chair pt wt<=300lb |
4,910 |
4,552 |
$34K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
608 |
520 |
$34K |
| A5063 |
Drain ostomy pouch w/flange |
622 |
585 |
$33K |
| A6196 |
Alginate dressing <=16 sq in |
309 |
270 |
$33K |
| A6216 |
Non-sterile gauze<=16 sq in |
2,784 |
2,593 |
$31K |
| E0181 |
Press pad alternating w/ pum |
2,711 |
2,587 |
$30K |
| A4628 |
Oropharyngeal suction cath |
4,185 |
3,763 |
$30K |
| A4427 |
Ost pch drain/barr lk flng/f |
625 |
586 |
$28K |
| E0940 |
Trapeze bar free standing |
2,385 |
2,237 |
$26K |
| A6446 |
Conform band s w>=3" <5"/yd |
1,107 |
958 |
$25K |
| E0135 |
Walker folding adjust/fixed |
609 |
586 |
$25K |
| K0739 |
Repair/svc dme non-oxygen eq |
2,606 |
2,223 |
$25K |
| E0261 |
Hosp bed semi-electr w/o mat |
403 |
390 |
$23K |
| L3660 |
So 8 ab rstr can/web pre ots |
404 |
383 |
$23K |
| A6198 |
Alginate dressing > 48 sq in |
51 |
38 |
$23K |
| A4554 |
Disposable underpads |
2,585 |
2,035 |
$23K |
| E0635 |
Patient lift electric |
918 |
881 |
$21K |
| A4357 |
Bedside drainage bag |
1,679 |
1,540 |
$19K |
| A6219 |
Gauze <= 16 sq in w/border |
937 |
793 |
$18K |
| A6449 |
Lt compres band >=3" <5"/yd |
573 |
480 |
$18K |
| E0185 |
Gel pressure mattress pad |
177 |
166 |
$17K |
| E0100 |
Cane adjust/fixed with tip |
1,785 |
1,698 |
$17K |
| A4520 |
Incontinence garment anytype |
1,324 |
1,126 |
$16K |
| A6240 |
Hydrocolld drg filler paste |
266 |
240 |
$16K |
| K0195 |
Elevating whlchair leg rests |
2,389 |
2,293 |
$15K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
202 |
179 |
$15K |
| A4553 |
Nondisp underpads, all sizes |
514 |
395 |
$14K |
| A4362 |
Solid skin barrier |
958 |
872 |
$14K |
| A5120 |
Skin barrier, wipe or swab |
1,577 |
1,479 |
$13K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
111 |
108 |
$12K |
| A7521 |
Trach/laryn tube cuffed |
322 |
283 |
$12K |
| A4456 |
Adhesive remover, wipes |
1,358 |
1,303 |
$12K |
| A6453 |
Self-adher band w <3"/yd |
5,211 |
4,932 |
$12K |
| A7002 |
Tubing used w suction pump |
2,291 |
2,070 |
$11K |
| E0434 |
Portable liquid 02 |
649 |
614 |
$11K |
| A6454 |
Self-adher band w>=3" <5"/yd |
417 |
311 |
$11K |
| A7003 |
Nebulizer administration set |
4,175 |
3,812 |
$10K |
| A6443 |
Conform band n/s w>=3"<5"/yd |
694 |
612 |
$10K |
| E0244 |
Toilet seat raised |
255 |
230 |
$10K |
| A7007 |
Lg vol nebulizer disposable |
2,015 |
1,858 |
$10K |
| A4332 |
Lube sterile packet |
1,361 |
1,247 |
$10K |
| A4349 |
Disposable male external cat |
602 |
552 |
$10K |
| A4406 |
Pectin based ostomy paste |
1,185 |
1,121 |
$9K |
| L1820 |
Ko elas w/ condyle pads & jo |
210 |
192 |
$8K |
| A6220 |
Gauze >16 <=48 sq in w/bordr |
133 |
116 |
$6K |
| A4358 |
Urinary leg or abdomen bag |
749 |
689 |
$6K |
| A4394 |
Ostomy pouch liq deodorant |
340 |
318 |
$6K |
| E0961 |
Wheelchair brake extension |
1,908 |
1,771 |
$6K |
| A4239 |
Non-adju cgm supply allow |
154 |
141 |
$5K |
| E0105 |
Cane adjust/fixed quad/3 pro |
250 |
230 |
$5K |
| E0978 |
W/c acc,saf belt pelv strap |
519 |
488 |
$5K |
| A9276 |
Disposable sensor, cgm sys |
51 |
48 |
$5K |
| A4245 |
Alcohol wipes per box |
269 |
245 |
$4K |
| A4314 |
Cath w/drainage 2-way latex |
285 |
271 |
$4K |
| L1833 |
Ko adj jnt pos r sup pre ots |
13 |
13 |
$3K |
| A4660 |
Sphyg/bp app w cuff and stet |
109 |
98 |
$3K |
| E1039 |
Transport chair pt wt >300lb |
227 |
214 |
$3K |
| A4371 |
Skin barrier powder per oz |
878 |
842 |
$3K |
| A4310 |
Insert tray w/o bag/cath |
96 |
91 |
$3K |
| A4369 |
Skin barrier liquid per oz |
498 |
477 |
$3K |
| E2611 |
Gen use back cush wdth <22in |
13 |
13 |
$2K |
| K0003 |
Lightweight wheelchair |
100 |
100 |
$2K |
| E0484 |
Non-elec oscillatory pep dvc |
119 |
113 |
$2K |
| A4618 |
Breathing circuits |
92 |
85 |
$2K |
| A6457 |
Tubular dressing |
47 |
41 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,686 |
1,605 |
$2K |
| E0951 |
Loop heel |
967 |
759 |
$1K |
| A6456 |
Zinc paste band w >=3"<5"/yd |
19 |
12 |
$1K |
| A6441 |
Pad band w>=3" <5"/yd |
49 |
37 |
$901.59 |
| A4367 |
Ostomy belt |
99 |
87 |
$861.81 |
| E0912 |
Hd trapeze bar free standing |
79 |
71 |
$789.83 |
| E0705 |
Transfer device |
27 |
27 |
$606.27 |
| A7525 |
Tracheostomy mask |
2,366 |
2,158 |
$549.91 |
| A6407 |
Packing strips, non-impreg |
35 |
32 |
$423.00 |
| A4402 |
Lubricant per ounce |
45 |
39 |
$238.18 |
| E0184 |
Dry pressure mattress |
12 |
12 |
$234.46 |
| A7013 |
Disposable compressor filter |
280 |
266 |
$186.38 |
| A4450 |
Non-waterproof tape |
60 |
48 |
$162.59 |
| A4344 |
Cath indw foley 2 way silicn |
13 |
12 |
$142.82 |
| E1020 |
Residual limb support system |
14 |
12 |
$98.84 |
| E0315 |
Bed accessory brd/tbl/supprt |
20 |
20 |
$93.50 |
| A9900 |
Supply/accessory/service |
17 |
13 |
$7.53 |
| A6250 |
Skin seal protect moisturizr |
24 |
22 |
$0.00 |