| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
42,272 |
41,464 |
$160K |
| T4541 |
Large disposable underpad |
50,200 |
48,399 |
$126K |
| E0601 |
Cont airway pressure device |
33,460 |
33,406 |
$95K |
| T4535 |
Disposable liner/shield/pad |
28,776 |
27,487 |
$57K |
| T4527 |
Adult size pull-on lg |
9,691 |
9,374 |
$48K |
| K0001 |
Standard wheelchair |
25,976 |
25,846 |
$46K |
| T4523 |
Adult size brief/diaper lg |
5,183 |
4,993 |
$37K |
| E0562 |
Humidifier heated used w pap |
38,698 |
38,592 |
$36K |
| T4526 |
Adult size pull-on med |
9,547 |
9,200 |
$36K |
| E0431 |
Portable gaseous 02 |
37,096 |
35,976 |
$26K |
| T4528 |
Adult size pull-on xl |
4,386 |
4,227 |
$25K |
| E0143 |
Walker folding wheeled w/o s |
8,246 |
8,148 |
$21K |
| E0570 |
Nebulizer with compression |
4,116 |
4,101 |
$15K |
| A4351 |
Straight tip urine catheter |
1,391 |
1,337 |
$15K |
| T4534 |
Youth size pull-on |
1,901 |
1,816 |
$13K |
| E0295 |
Hosp bed semi-elect w/o matt |
3,588 |
3,582 |
$11K |
| A7030 |
Cpap full face mask |
1,971 |
1,944 |
$11K |
| E0114 |
Crutch underarm pair no wood |
364 |
358 |
$10K |
| K0003 |
Lightweight wheelchair |
3,993 |
3,976 |
$9K |
| T4522 |
Adult size brief/diaper med |
3,477 |
3,353 |
$9K |
| E0470 |
Rad w/o backup non-inv intfc |
2,933 |
2,931 |
$8K |
| A7035 |
Pos airway press headgear |
6,226 |
6,108 |
$7K |
| A7034 |
Nasal application device |
2,976 |
2,943 |
$7K |
| T4524 |
Adult size brief/diaper xl |
2,517 |
2,440 |
$6K |
| A9276 |
Disposable sensor, cgm sys |
5,183 |
5,025 |
$6K |
| A7031 |
Replacement facemask interfa |
2,351 |
2,318 |
$6K |
| A7038 |
Pos airway pressure filter |
6,672 |
6,629 |
$6K |
| A7037 |
Pos airway pressure tubing |
5,083 |
5,052 |
$5K |
| E1392 |
Portable oxygen concentrator |
4,534 |
4,472 |
$4K |
| K0007 |
Extra heavy duty wheelchair |
1,146 |
1,141 |
$4K |
| A4927 |
Non-sterile gloves |
10,781 |
10,400 |
$4K |
| K0195 |
Elevating whlchair leg rests |
5,885 |
5,819 |
$4K |
| A4670 |
Automatic bp monitor, dial |
805 |
798 |
$3K |
| A6250 |
Skin seal protect moisturizr |
22,164 |
19,635 |
$3K |
| E0603 |
Electric breast pump |
5,595 |
5,578 |
$3K |
| E0163 |
Commode chair with fixed arm |
1,649 |
1,642 |
$3K |
| B4035 |
Enteral feed supp pump per d |
509 |
456 |
$3K |
| T4525 |
Adult size pull-on sm |
1,234 |
1,180 |
$2K |
| E0156 |
Walker seat attachment |
2,437 |
2,408 |
$2K |
| E0443 |
Portable 02 contents, gas |
102 |
73 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
3,583 |
3,409 |
$2K |
| A4253 |
Blood glucose/reagent strips |
10,308 |
9,994 |
$2K |
| A4224 |
Supply insulin inf cath/wk |
3,647 |
3,526 |
$2K |
| E0305 |
Rails bed side half length |
3,578 |
3,515 |
$1K |
| B9998 |
Enteral supp not otherwise c |
258 |
230 |
$1K |
| L3670 |
So acro/clav can web pre ots |
13 |
13 |
$1K |
| A4385 |
Ost skn barrier sld ext wear |
221 |
213 |
$971.54 |
| A4604 |
Tubing with heating element |
503 |
501 |
$965.00 |
| E0260 |
Hosp bed semi-electr w/ matt |
114 |
113 |
$899.54 |
| A5500 |
Diab shoe for density insert |
1,711 |
1,710 |
$828.05 |
| A5513 |
Multi den insert custom mold |
710 |
709 |
$810.36 |
| E0240 |
Bath/shower chair |
1,021 |
1,019 |
$798.23 |
| A6216 |
Non-sterile gauze<=16 sq in |
4,125 |
3,916 |
$773.82 |
| L1830 |
Ko immob canvas long pre ots |
12 |
12 |
$751.08 |
| A4225 |
Sup/ext insulin inf pump syr |
3,626 |
3,517 |
$736.80 |
| L3908 |
Who cock-up nonmolde pre ots |
440 |
439 |
$679.22 |
| T4530 |
Ped size brief/diaper lg |
592 |
561 |
$644.94 |
| E0277 |
Powered pres-redu air mattrs |
1,145 |
1,109 |
$611.05 |
| A7046 |
Repl water chamber, pap dev |
580 |
576 |
$480.88 |
| E0630 |
Patient lift hydraulic |
98 |
97 |
$454.23 |
| A5120 |
Skin barrier, wipe or swab |
1,805 |
1,738 |
$403.14 |
| A4259 |
Lancets per box |
9,619 |
9,352 |
$259.64 |
| B9002 |
Enter nutr inf pump any type |
272 |
267 |
$250.60 |
| E0310 |
Rails bed side full length |
189 |
189 |
$238.18 |
| A4456 |
Adhesive remover, wipes |
1,216 |
1,177 |
$224.72 |
| A7033 |
Replacement nasal pillows |
221 |
214 |
$209.95 |
| A4216 |
Sterile water/saline, 10 ml |
1,629 |
1,560 |
$194.87 |
| K0052 |
Swingaway detach ftrest repl |
401 |
398 |
$180.73 |
| A7000 |
Disposable canister for pump |
205 |
113 |
$167.75 |
| A4217 |
Sterile water/saline, 500 ml |
978 |
922 |
$99.97 |
| E0184 |
Dry pressure mattress |
76 |
75 |
$99.41 |
| A7015 |
Aerosol mask used w nebulize |
1,892 |
1,871 |
$96.58 |
| A6260 |
Wound cleanser any type/size |
220 |
212 |
$86.28 |
| B4160 |
Ef ped caloric dense>/=0.7kc |
475 |
437 |
$81.00 |
| A6446 |
Conform band s w>=3" <5"/yd |
635 |
602 |
$42.68 |
| E0607 |
Blood glucose monitor home |
368 |
368 |
$42.34 |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
67 |
64 |
$39.29 |
| E1226 |
Manual fully reclining back |
24 |
24 |
$34.83 |
| A4213 |
20+ cc syringe only |
513 |
471 |
$29.44 |
| E0971 |
Wheelchair anti-tipping devi |
40 |
40 |
$24.21 |
| A4450 |
Non-waterproof tape |
2,094 |
1,998 |
$10.42 |
| A4452 |
Waterproof tape |
503 |
475 |
$9.29 |
| A4615 |
Cannula nasal |
14 |
12 |
$8.07 |
| A6443 |
Conform band n/s w>=3"<5"/yd |
239 |
224 |
$3.49 |
| A6550 |
Neg pres wound ther drsg set |
18 |
12 |
$2.18 |
| E1038 |
Transport chair pt wt<=300lb |
363 |
363 |
$0.00 |
| A9270 |
Non-covered item or service |
1,387 |
1,335 |
$0.00 |
| E0600 |
Suction pump portab hom modl |
39 |
36 |
$0.00 |
| L4360 |
Pneumat walking boot pre cst |
176 |
176 |
$0.00 |
| A7032 |
Replacement nasal cushion |
141 |
140 |
$0.00 |
| E0604 |
Hosp grade elec breast pump |
3,286 |
3,283 |
$0.00 |
| T4537 |
Reusable underpad bed size |
567 |
557 |
$0.00 |
| T4536 |
Reusable pull-on any size |
3,402 |
3,302 |
$0.00 |
| B4161 |
Ef ped hydrolyzed/amino acid |
67 |
65 |
$0.00 |
| A4335 |
Incontinence supply |
456 |
447 |
$0.00 |
| E0100 |
Cane adjust/fixed with tip |
98 |
98 |
$0.00 |
| A4371 |
Skin barrier powder per oz |
119 |
117 |
$0.00 |
| L1810 |
Ko elastic with joints |
40 |
39 |
$0.00 |
| E0303 |
Hosp bed hvy dty xtra wide |
52 |
49 |
$0.00 |
| E0105 |
Cane adjust/fixed quad/3 pro |
12 |
12 |
$0.00 |
| E0776 |
Iv pole |
36 |
36 |
$0.00 |
| B4150 |
Ef complet w/intact nutrient |
27 |
25 |
$0.00 |
| 99203 |
|
120 |
120 |
$0.00 |
| A4245 |
Alcohol wipes per box |
38 |
38 |
$0.00 |
| A9274 |
Ext amb insulin delivery sys |
744 |
720 |
$0.00 |
| T4531 |
Ped size pull-on sm/med |
24 |
24 |
$0.00 |
| A9277 |
External transmitter, cgm |
1,258 |
1,257 |
$0.00 |
| A4357 |
Bedside drainage bag |
382 |
369 |
$0.00 |
| A7036 |
Pos airway press chinstrap |
102 |
100 |
$0.00 |
| T4542 |
Small disposable underpad |
170 |
162 |
$0.00 |
| T4544 |
Adlt disp und/pull on abv xl |
128 |
112 |
$0.00 |
| A5512 |
Multi den insert direct form |
91 |
91 |
$0.00 |
| A4246 |
Betadine/phisohex solution |
13 |
12 |
$0.00 |
| A4649 |
Surgical supplies |
64 |
57 |
$0.00 |
| E0471 |
Rad w/backup non inv intrfc |
128 |
127 |
$0.00 |
| L1820 |
Ko elas w/ condyle pads & jo |
12 |
12 |
$0.00 |
| L3807 |
Whfo w/o joints pre cst |
12 |
12 |
$0.00 |
| E2402 |
Neg press wound therapy pump |
40 |
37 |
$0.00 |
| A4409 |
Ost skn barr convex <=4 sq i |
12 |
12 |
$0.00 |
| T4521 |
Adult size brief/diaper sm |
15 |
13 |
$0.00 |
| E0445 |
Oximeter non-invasive |
19 |
19 |
$0.00 |