| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,444 |
6,069 |
$366K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,682 |
2,099 |
$356K |
| B4035 |
Enteral feed supp pump per d |
2,453 |
1,904 |
$353K |
| T4522 |
Adult size brief/diaper med |
1,327 |
1,248 |
$160K |
| T4523 |
Adult size brief/diaper lg |
1,339 |
1,256 |
$154K |
| T4526 |
Adult size pull-on med |
1,660 |
1,539 |
$153K |
| T4527 |
Adult size pull-on lg |
1,534 |
1,406 |
$148K |
| E0601 |
Cont airway pressure device |
4,223 |
3,822 |
$131K |
| T4528 |
Adult size pull-on xl |
1,264 |
1,180 |
$129K |
| A7030 |
Cpap full face mask |
1,896 |
1,719 |
$113K |
| A7031 |
Replacement facemask interfa |
2,559 |
2,315 |
$107K |
| A4335 |
Incontinence supply |
4,500 |
3,991 |
$104K |
| B4150 |
Ef complet w/intact nutrient |
1,528 |
1,069 |
$97K |
| S9977 |
Meals per diem |
730 |
639 |
$91K |
| T4535 |
Disposable liner/shield/pad |
1,516 |
1,380 |
$86K |
| E0570 |
Nebulizer with compression |
2,803 |
2,621 |
$81K |
| A4604 |
Tubing with heating element |
3,048 |
2,778 |
$80K |
| B4036 |
Enteral feed sup kit grav by |
1,039 |
730 |
$64K |
| E0603 |
Electric breast pump |
570 |
506 |
$60K |
| E1392 |
Portable oxygen concentrator |
3,417 |
3,246 |
$60K |
| E0562 |
Humidifier heated used w pap |
4,497 |
4,037 |
$50K |
| B4161 |
Ef ped hydrolyzed/amino acid |
75 |
64 |
$48K |
| T4541 |
Large disposable underpad |
1,246 |
1,169 |
$36K |
| E1028 |
W/c manual swingaway |
998 |
674 |
$35K |
| K0001 |
Standard wheelchair |
2,124 |
1,867 |
$35K |
| A7035 |
Pos airway press headgear |
2,126 |
1,936 |
$31K |
| E0118 |
Crutch substitute |
615 |
564 |
$29K |
| E0143 |
Walker folding wheeled w/o s |
669 |
631 |
$28K |
| B4088 |
Gastro/jejuno tube, low-pro |
505 |
400 |
$28K |
| B9002 |
Enter nutr inf pump any type |
446 |
380 |
$27K |
| E0470 |
Rad w/o backup non-inv intfc |
320 |
288 |
$23K |
| A7038 |
Pos airway pressure filter |
3,807 |
3,416 |
$22K |
| A7034 |
Nasal application device |
541 |
500 |
$20K |
| A7005 |
Nondisposable nebulizer set |
1,034 |
957 |
$19K |
| E1161 |
Manual adult wc w tiltinspac |
121 |
116 |
$13K |
| T4544 |
Adlt disp und/pull on abv xl |
121 |
114 |
$12K |
| A7046 |
Repl water chamber, pap dev |
1,427 |
1,304 |
$12K |
| A4927 |
Non-sterile gloves |
794 |
708 |
$11K |
| B4152 |
Ef calorie dense>/=1.5kcal |
148 |
113 |
$11K |
| T4524 |
Adult size brief/diaper xl |
91 |
85 |
$10K |
| E0114 |
Crutch underarm pair no wood |
231 |
218 |
$9K |
| T4534 |
Youth size pull-on |
109 |
86 |
$9K |
| A4357 |
Bedside drainage bag |
1,108 |
1,039 |
$9K |
| E0431 |
Portable gaseous 02 |
604 |
551 |
$8K |
| E0776 |
Iv pole |
1,325 |
1,253 |
$5K |
| A7032 |
Replacement nasal cushion |
164 |
150 |
$4K |
| A4627 |
Spacer bag/reservoir |
157 |
149 |
$3K |
| T2029 |
Special med equip, noswaiver |
14 |
12 |
$3K |
| A4351 |
Straight tip urine catheter |
14 |
12 |
$2K |
| K0823 |
Pwc gp 2 std cap chair |
26 |
24 |
$1K |
| E0955 |
Cushioned headrest |
140 |
136 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
192 |
180 |
$839.77 |
| A4314 |
Cath w/drainage 2-way latex |
66 |
61 |
$593.50 |
| K0195 |
Elevating whlchair leg rests |
98 |
89 |
$566.89 |
| K0739 |
Repair/svc dme non-oxygen eq |
13 |
12 |
$336.69 |
| A9999 |
Dme supply or accessory, nos |
17 |
12 |
$303.66 |
| A7003 |
Nebulizer administration set |
50 |
41 |
$184.21 |
| A6402 |
Sterile gauze <= 16 sq in |
15 |
12 |
$172.70 |
| A7015 |
Aerosol mask used w nebulize |
72 |
66 |
$111.83 |
| A4334 |
Urinary cath leg strap |
37 |
36 |
$109.73 |