| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
33,837 |
31,296 |
$3.42M |
| E0601 |
Cont airway pressure device |
14,143 |
13,256 |
$2.21M |
| E0603 |
Electric breast pump |
11,184 |
10,851 |
$2.18M |
| A9276 |
Disposable sensor, cgm sys |
1,912 |
1,850 |
$1.81M |
| B4035 |
Enteral feed supp pump per d |
6,056 |
5,249 |
$1.66M |
| A4253 |
Blood glucose/reagent strips |
13,708 |
12,811 |
$1.52M |
| L4361 |
Pneuma/vac walk boot pre ots |
5,793 |
5,472 |
$1.50M |
| A7030 |
Cpap full face mask |
12,045 |
11,627 |
$1.40M |
| E0465 |
Home vent invasive interface |
1,881 |
1,209 |
$1.24M |
| B4149 |
Ef blenderized foods |
1,223 |
1,121 |
$1.22M |
| A7034 |
Nasal application device |
13,829 |
13,358 |
$1.08M |
| A4604 |
Tubing with heating element |
22,016 |
21,308 |
$947K |
| A7031 |
Replacement facemask interfa |
10,768 |
10,394 |
$794K |
| E0260 |
Hosp bed semi-electr w/ matt |
15,482 |
13,928 |
$747K |
| A4239 |
Non-adju cgm supply allow |
761 |
747 |
$682K |
| E1399 |
Durable medical equipment mi |
3,045 |
1,576 |
$669K |
| T4527 |
Adult size pull-on lg |
6,922 |
6,712 |
$659K |
| T4535 |
Disposable liner/shield/pad |
10,581 |
9,525 |
$657K |
| E0562 |
Humidifier heated used w pap |
17,848 |
16,633 |
$639K |
| T4526 |
Adult size pull-on med |
7,610 |
7,371 |
$636K |
| E0470 |
Rad w/o backup non-inv intfc |
2,170 |
2,022 |
$627K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,441 |
2,215 |
$620K |
| A7032 |
Replacement nasal cushion |
6,945 |
6,669 |
$611K |
| E2510 |
Sgd w multi methods msg/accs |
128 |
126 |
$597K |
| L3809 |
Whfo w/o joints pre ots |
3,468 |
3,267 |
$594K |
| T4528 |
Adult size pull-on xl |
5,473 |
5,312 |
$556K |
| E0143 |
Walker folding wheeled w/o s |
9,038 |
8,323 |
$546K |
| B4161 |
Ef ped hydrolyzed/amino acid |
606 |
555 |
$536K |
| B4150 |
Ef complet w/intact nutrient |
3,263 |
2,897 |
$517K |
| T4534 |
Youth size pull-on |
6,416 |
6,220 |
$477K |
| A9277 |
External transmitter, cgm |
1,316 |
1,290 |
$453K |
| A7035 |
Pos airway press headgear |
16,492 |
15,867 |
$449K |
| B9998 |
Enteral supp not otherwise c |
6,660 |
5,921 |
$445K |
| E0570 |
Nebulizer with compression |
6,030 |
5,481 |
$438K |
| A4230 |
Infus insulin pump non needl |
1,704 |
1,636 |
$419K |
| K0108 |
W/c component-accessory nos |
2,170 |
1,307 |
$417K |
| A4927 |
Non-sterile gloves |
30,539 |
28,662 |
$397K |
| E0114 |
Crutch underarm pair no wood |
9,762 |
9,226 |
$389K |
| T4541 |
Large disposable underpad |
18,631 |
18,146 |
$388K |
| K0001 |
Standard wheelchair |
16,830 |
15,271 |
$383K |
| E0431 |
Portable gaseous 02 |
22,856 |
21,367 |
$382K |
| A7033 |
Replacement nasal pillows |
5,624 |
5,403 |
$381K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,168 |
1,854 |
$376K |
| L3670 |
So acro/clav can web pre ots |
4,097 |
3,953 |
$358K |
| E0471 |
Rad w/backup non inv intrfc |
746 |
697 |
$351K |
| A4351 |
Straight tip urine catheter |
1,095 |
1,047 |
$343K |
| A7038 |
Pos airway pressure filter |
27,616 |
26,573 |
$330K |
| T4523 |
Adult size brief/diaper lg |
3,240 |
3,135 |
$310K |
| L3908 |
Who cock-up nonmolde pre ots |
5,264 |
4,814 |
$293K |
| A4215 |
Sterile needle |
3,108 |
2,958 |
$274K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,810 |
1,711 |
$268K |
| B4034 |
Enter feed supkit syr by day |
2,187 |
1,904 |
$241K |
| B4036 |
Enteral feed sup kit grav by |
1,718 |
1,433 |
$214K |
| A5513 |
Multi den insert custom mold |
1,252 |
1,219 |
$210K |
| K0553 |
Ther cgm supply allowance |
278 |
266 |
$210K |
| E1392 |
Portable oxygen concentrator |
2,447 |
2,139 |
$208K |
| T4524 |
Adult size brief/diaper xl |
1,981 |
1,909 |
$203K |
| B4153 |
Ef hydrolyzed/amino acids |
371 |
325 |
$203K |
| A4259 |
Lancets per box |
9,451 |
8,855 |
$198K |
| L4350 |
Ankle control ortho pre ots |
2,791 |
2,627 |
$194K |
| T4522 |
Adult size brief/diaper med |
2,233 |
2,158 |
$183K |
| T4530 |
Ped size brief/diaper lg |
2,350 |
2,277 |
$179K |
| A4385 |
Ost skn barrier sld ext wear |
1,249 |
1,219 |
$173K |
| K0007 |
Extra heavy duty wheelchair |
1,791 |
1,604 |
$171K |
| T4543 |
Adult disp brief/diap abv xl |
1,108 |
1,072 |
$160K |
| L1830 |
Ko immob canvas long pre ots |
2,137 |
2,018 |
$160K |
| A4225 |
Sup/ext insulin inf pump syr |
1,796 |
1,756 |
$157K |
| A7046 |
Repl water chamber, pap dev |
9,610 |
9,274 |
$148K |
| E0630 |
Patient lift hydraulic |
4,023 |
3,593 |
$145K |
| L1902 |
Afo ankle gauntlet pre ots |
1,730 |
1,690 |
$144K |
| B9002 |
Enter nutr inf pump any type |
1,436 |
1,357 |
$137K |
| K0006 |
Heavy duty wheelchair |
1,990 |
1,804 |
$125K |
| B4154 |
Ef spec metabolic noninherit |
656 |
582 |
$120K |
| A5500 |
Diab shoe for density insert |
1,509 |
1,459 |
$120K |
| A7000 |
Disposable canister for pump |
2,459 |
2,118 |
$116K |
| K0739 |
Repair/svc dme non-oxygen eq |
2,114 |
1,982 |
$96K |
| T4537 |
Reusable underpad bed size |
3,583 |
3,526 |
$90K |
| L1812 |
Ko elastic w/joints pre ots |
1,267 |
1,195 |
$88K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
5,044 |
4,610 |
$83K |
| E2402 |
Neg press wound therapy pump |
82 |
52 |
$82K |
| E0202 |
Phototherapy light w/ photom |
1,340 |
544 |
$82K |
| E0445 |
Oximeter non-invasive |
618 |
589 |
$81K |
| A4623 |
Tracheostomy inner cannula |
622 |
499 |
$81K |
| T4544 |
Adlt disp und/pull on abv xl |
900 |
859 |
$77K |
| A7526 |
Tracheostomy tube collar |
1,236 |
1,089 |
$75K |
| E0245 |
Tub stool or bench |
1,992 |
1,764 |
$70K |
| A4624 |
Tracheal suction tube |
749 |
597 |
$69K |
| K0195 |
Elevating whlchair leg rests |
6,073 |
5,600 |
$65K |
| E0600 |
Suction pump portab hom modl |
2,592 |
2,341 |
$61K |
| A4670 |
Automatic bp monitor, dial |
1,063 |
1,029 |
$58K |
| E1028 |
W/c manual swingaway |
439 |
290 |
$58K |
| A4217 |
Sterile water/saline, 500 ml |
1,142 |
925 |
$56K |
| A7037 |
Pos airway pressure tubing |
1,921 |
1,859 |
$53K |
| E0149 |
Heavy duty wheeled walker |
769 |
708 |
$45K |
| B4155 |
Ef incomplete/modular |
1,192 |
1,107 |
$45K |
| T4532 |
Ped size pull-on lg |
612 |
579 |
$45K |
| A4605 |
Trach suction cath close sys |
516 |
440 |
$42K |
| E0156 |
Walker seat attachment |
3,096 |
2,847 |
$39K |
| E0247 |
Trans bench w/wo comm open |
504 |
460 |
$37K |
| K0003 |
Lightweight wheelchair |
1,274 |
1,185 |
$36K |
| A4606 |
Oxygen probe used w oximeter |
649 |
537 |
$34K |
| L4360 |
Pneumat walking boot pre cst |
171 |
169 |
$33K |
| T4525 |
Adult size pull-on sm |
347 |
345 |
$27K |
| E0163 |
Commode chair with fixed arm |
773 |
677 |
$27K |
| A7003 |
Nebulizer administration set |
5,553 |
5,033 |
$24K |
| A4216 |
Sterile water/saline, 10 ml |
630 |
544 |
$23K |
| E0971 |
Wheelchair anti-tipping devi |
4,541 |
2,859 |
$22K |
| A7039 |
Filter, non disposable w pap |
2,159 |
2,058 |
$21K |
| A4629 |
Tracheostomy care kit |
244 |
218 |
$20K |
| A4362 |
Solid skin barrier |
259 |
255 |
$19K |
| E0181 |
Press pad alternating w/ pum |
1,765 |
1,601 |
$19K |
| A7521 |
Trach/laryn tube cuffed |
122 |
100 |
$17K |
| A4394 |
Ostomy pouch liq deodorant |
228 |
221 |
$17K |
| A7002 |
Tubing used w suction pump |
2,058 |
1,715 |
$17K |
| A6402 |
Sterile gauze <= 16 sq in |
1,929 |
1,639 |
$17K |
| E2601 |
Gen w/c cushion wdth < 22 in |
425 |
385 |
$16K |
| A4456 |
Adhesive remover, wipes |
1,163 |
1,132 |
$16K |
| E0294 |
Hosp bed semi-elect w/ mattr |
330 |
293 |
$14K |
| A5057 |
1 pc ost pou w built-in conv |
51 |
51 |
$14K |
| K0738 |
Portable gas oxygen system |
535 |
515 |
$13K |
| L1833 |
Ko adj jnt pos r sup pre ots |
25 |
25 |
$11K |
| A4618 |
Breathing circuits |
462 |
345 |
$11K |
| A4357 |
Bedside drainage bag |
582 |
566 |
$11K |
| A7036 |
Pos airway press chinstrap |
815 |
789 |
$10K |
| E0277 |
Powered pres-redu air mattrs |
57 |
40 |
$9K |
| K0554 |
Ther cgm receiver/monitor |
20 |
18 |
$9K |
| S8490 |
100 insulin syringes |
196 |
173 |
$9K |
| E0100 |
Cane adjust/fixed with tip |
621 |
577 |
$9K |
| A4628 |
Oropharyngeal suction cath |
1,154 |
952 |
$8K |
| E0482 |
Cough stimulating device |
24 |
24 |
$7K |
| E0973 |
W/ch access det adj armrest |
44 |
42 |
$6K |
| E1226 |
Manual fully reclining back |
143 |
130 |
$6K |
| A6212 |
Foam drg <=16 sq in w/border |
70 |
64 |
$6K |
| A4206 |
1 cc sterile syringe&needle |
77 |
68 |
$5K |
| E2361 |
22nf sealed leadacid battery |
24 |
24 |
$4K |
| A5120 |
Skin barrier, wipe or swab |
721 |
706 |
$4K |
| L2820 |
Soft interface below knee se |
40 |
38 |
$4K |
| E2202 |
Seat width 24-27 in |
185 |
161 |
$3K |
| K0053 |
Elevate footrest articulate |
562 |
501 |
$3K |
| L2275 |
Plastic mod low ext pad/line |
13 |
12 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
1,712 |
1,618 |
$2K |
| A4407 |
Ext wear ost skn barr <=4sq" |
13 |
13 |
$2K |
| L1820 |
Ko elas w/ condyle pads & jo |
14 |
14 |
$2K |
| A4520 |
Incontinence garment anytype |
49 |
49 |
$2K |
| B4087 |
Gastro/jejuno tube, std |
73 |
65 |
$2K |
| E0244 |
Toilet seat raised |
86 |
77 |
$2K |
| L3260 |
Ambulatory surgical boot eac |
87 |
85 |
$2K |
| A4565 |
Slings |
240 |
233 |
$2K |
| A4371 |
Skin barrier powder per oz |
222 |
214 |
$1K |
| E0910 |
Trapeze bar attached to bed |
184 |
175 |
$1K |
| E0978 |
W/c acc,saf belt pelv strap |
55 |
54 |
$1K |
| A4425 |
Ost pch drain for barrier fl |
14 |
14 |
$1K |
| L3660 |
So 8 ab rstr can/web pre ots |
12 |
12 |
$975.00 |
| E0776 |
Iv pole |
62 |
62 |
$927.56 |
| A4369 |
Skin barrier liquid per oz |
70 |
69 |
$343.39 |
| A4455 |
Adhesive remover per ounce |
64 |
62 |
$304.42 |
| E0241 |
Bath tub wall rail |
17 |
12 |
$304.05 |
| A4615 |
Cannula nasal |
241 |
187 |
$250.32 |
| A4322 |
Irrigation syringe |
12 |
12 |
$238.39 |
| A7525 |
Tracheostomy mask |
17 |
12 |
$29.45 |