| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
52,843 |
51,913 |
$6.26M |
| B4150 |
Ef complet w/intact nutrient |
2,782 |
2,561 |
$4.35M |
| T4541 |
Large disposable underpad |
54,469 |
53,080 |
$3.43M |
| E0601 |
Cont airway pressure device |
40,509 |
40,270 |
$2.84M |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,076 |
1,026 |
$2.03M |
| T4535 |
Disposable liner/shield/pad |
24,850 |
24,220 |
$1.99M |
| E0470 |
Rad w/o backup non-inv intfc |
8,888 |
8,844 |
$1.62M |
| K0001 |
Standard wheelchair |
40,300 |
39,442 |
$1.47M |
| E0562 |
Humidifier heated used w pap |
10,553 |
10,342 |
$1.44M |
| T4527 |
Adult size pull-on lg |
15,488 |
15,173 |
$1.41M |
| A7030 |
Cpap full face mask |
11,279 |
11,206 |
$1.28M |
| A4351 |
Straight tip urine catheter |
2,666 |
2,546 |
$1.24M |
| E0471 |
Rad w/backup non inv intrfc |
2,608 |
2,589 |
$1.18M |
| A7034 |
Nasal application device |
14,038 |
13,928 |
$1.18M |
| T4526 |
Adult size pull-on med |
17,127 |
16,753 |
$1.17M |
| E0466 |
Home vent non-invasive inter |
1,204 |
988 |
$1.12M |
| T4534 |
Youth size pull-on |
4,135 |
4,036 |
$1.05M |
| A4604 |
Tubing with heating element |
18,844 |
18,672 |
$953K |
| A7038 |
Pos airway pressure filter |
25,700 |
25,305 |
$928K |
| T4528 |
Adult size pull-on xl |
9,555 |
9,366 |
$868K |
| E0431 |
Portable gaseous 02 |
38,834 |
38,141 |
$823K |
| T4523 |
Adult size brief/diaper lg |
6,621 |
6,455 |
$816K |
| A6250 |
Skin seal protect moisturizr |
43,758 |
42,644 |
$710K |
| E0570 |
Nebulizer with compression |
8,447 |
8,181 |
$702K |
| E0143 |
Walker folding wheeled w/o s |
12,825 |
12,591 |
$702K |
| A7035 |
Pos airway press headgear |
24,300 |
24,149 |
$687K |
| E0445 |
Oximeter non-invasive |
3,194 |
3,172 |
$684K |
| E0277 |
Powered pres-redu air mattrs |
1,532 |
1,418 |
$644K |
| A4335 |
Incontinence supply |
43,177 |
42,049 |
$637K |
| A4409 |
Ost skn barr convex <=4 sq i |
1,763 |
1,730 |
$560K |
| E0295 |
Hosp bed semi-elect w/o matt |
6,635 |
6,566 |
$550K |
| A4385 |
Ost skn barrier sld ext wear |
2,926 |
2,868 |
$546K |
| T4522 |
Adult size brief/diaper med |
5,497 |
5,358 |
$543K |
| T4524 |
Adult size brief/diaper xl |
4,216 |
4,128 |
$521K |
| B4035 |
Enteral feed supp pump per d |
4,073 |
3,454 |
$511K |
| E0465 |
Home vent invasive interface |
574 |
373 |
$481K |
| K0007 |
Extra heavy duty wheelchair |
3,315 |
3,265 |
$456K |
| E1392 |
Portable oxygen concentrator |
11,373 |
11,258 |
$418K |
| A4670 |
Automatic bp monitor, dial |
5,372 |
5,222 |
$411K |
| K0003 |
Lightweight wheelchair |
7,653 |
7,519 |
$376K |
| E0245 |
Tub stool or bench |
6,463 |
6,390 |
$354K |
| A7032 |
Replacement nasal cushion |
5,709 |
5,670 |
$339K |
| A4927 |
Non-sterile gloves |
17,698 |
17,034 |
$338K |
| A7031 |
Replacement facemask interfa |
6,601 |
6,547 |
$320K |
| B4153 |
Ef hydrolyzed/amino acids |
155 |
150 |
$292K |
| A4425 |
Ost pch drain for barrier fl |
1,901 |
1,860 |
$281K |
| A7033 |
Replacement nasal pillows |
3,965 |
3,918 |
$234K |
| A4407 |
Ext wear ost skn barr <=4sq" |
663 |
649 |
$208K |
| T4525 |
Adult size pull-on sm |
3,005 |
2,934 |
$205K |
| K0195 |
Elevating whlchair leg rests |
12,340 |
11,724 |
$198K |
| E0600 |
Suction pump portab hom modl |
3,471 |
3,381 |
$190K |
| E0483 |
Hi freq chest wall oscil sys |
149 |
149 |
$185K |
| A7520 |
Trach/laryn tube non-cuffed |
1,369 |
1,271 |
$182K |
| K0108 |
W/c component-accessory nos |
1,040 |
388 |
$177K |
| E0163 |
Commode chair with fixed arm |
2,637 |
2,598 |
$174K |
| T4530 |
Ped size brief/diaper lg |
1,362 |
1,342 |
$171K |
| A7037 |
Pos airway pressure tubing |
6,314 |
6,275 |
$168K |
| A7039 |
Filter, non disposable w pap |
15,454 |
15,311 |
$162K |
| A4624 |
Tracheal suction tube |
1,984 |
1,893 |
$161K |
| A4606 |
Oxygen probe used w oximeter |
1,989 |
1,887 |
$158K |
| A7526 |
Tracheostomy tube collar |
1,794 |
1,723 |
$153K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,289 |
4,240 |
$148K |
| B4034 |
Enter feed supkit syr by day |
1,923 |
1,643 |
$143K |
| E1399 |
Durable medical equipment mi |
176 |
125 |
$138K |
| A4362 |
Solid skin barrier |
553 |
540 |
$137K |
| B4088 |
Gastro/jejuno tube, low-pro |
868 |
850 |
$128K |
| E0630 |
Patient lift hydraulic |
2,794 |
2,728 |
$127K |
| A4629 |
Tracheostomy care kit |
1,015 |
973 |
$118K |
| A7000 |
Disposable canister for pump |
5,274 |
5,145 |
$117K |
| E0156 |
Walker seat attachment |
8,414 |
8,256 |
$115K |
| B9002 |
Enter nutr inf pump any type |
1,366 |
1,354 |
$113K |
| A7005 |
Nondisposable nebulizer set |
4,393 |
4,312 |
$102K |
| E0247 |
Trans bench w/wo comm open |
1,196 |
1,180 |
$99K |
| E0305 |
Rails bed side half length |
7,550 |
7,451 |
$97K |
| A5057 |
1 pc ost pou w built-in conv |
250 |
249 |
$96K |
| A4357 |
Bedside drainage bag |
1,737 |
1,685 |
$90K |
| E0271 |
Mattress innerspring |
5,456 |
5,400 |
$87K |
| T4521 |
Adult size brief/diaper sm |
893 |
875 |
$80K |
| K0823 |
Pwc gp 2 std cap chair |
319 |
303 |
$80K |
| E0149 |
Heavy duty wheeled walker |
1,928 |
1,872 |
$77K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
347 |
346 |
$74K |
| E1226 |
Manual fully reclining back |
1,868 |
1,839 |
$69K |
| A5513 |
Multi den insert custom mold |
543 |
543 |
$64K |
| A6212 |
Foam drg <=16 sq in w/border |
227 |
216 |
$62K |
| T5999 |
Supply, nos |
2,360 |
2,318 |
$62K |
| E0303 |
Hosp bed hvy dty xtra wide |
380 |
372 |
$62K |
| T4544 |
Adlt disp und/pull on abv xl |
101 |
101 |
$59K |
| A4628 |
Oropharyngeal suction cath |
5,158 |
4,774 |
$58K |
| A4456 |
Adhesive remover, wipes |
3,159 |
3,118 |
$58K |
| E0635 |
Patient lift electric |
549 |
549 |
$54K |
| E0730 |
Tens four lead |
302 |
299 |
$49K |
| A4394 |
Ostomy pouch liq deodorant |
1,883 |
1,851 |
$49K |
| B9998 |
Enteral supp not otherwise c |
264 |
244 |
$48K |
| E0244 |
Toilet seat raised |
981 |
967 |
$45K |
| A5500 |
Diab shoe for density insert |
583 |
583 |
$44K |
| E1038 |
Transport chair pt wt<=300lb |
3,540 |
3,472 |
$43K |
| A4338 |
Indwelling catheter latex |
446 |
430 |
$41K |
| K0739 |
Repair/svc dme non-oxygen eq |
510 |
473 |
$40K |
| A4358 |
Urinary leg or abdomen bag |
1,013 |
964 |
$38K |
| E0603 |
Electric breast pump |
369 |
367 |
$37K |
| A5120 |
Skin barrier, wipe or swab |
2,872 |
2,803 |
$36K |
| E0100 |
Cane adjust/fixed with tip |
2,545 |
2,526 |
$36K |
| A4310 |
Insert tray w/o bag/cath |
518 |
507 |
$33K |
| T4543 |
Adult disp brief/diap abv xl |
111 |
111 |
$32K |
| A5056 |
1 pc ost pouch w filter |
160 |
159 |
$31K |
| A4432 |
Os pch urine w bar/fange/tap |
243 |
240 |
$31K |
| A4349 |
Disposable male external cat |
453 |
435 |
$30K |
| A7002 |
Tubing used w suction pump |
4,722 |
4,622 |
$29K |
| E0105 |
Cane adjust/fixed quad/3 pro |
886 |
877 |
$28K |
| A4406 |
Pectin based ostomy paste |
1,261 |
1,233 |
$26K |
| E0240 |
Bath/shower chair |
39 |
39 |
$25K |
| A4623 |
Tracheostomy inner cannula |
130 |
127 |
$25K |
| A4367 |
Ostomy belt |
1,559 |
1,537 |
$24K |
| E0297 |
Hosp bed total elect w/o mat |
238 |
238 |
$24K |
| A7036 |
Pos airway press chinstrap |
1,419 |
1,413 |
$20K |
| T4531 |
Ped size pull-on sm/med |
76 |
61 |
$20K |
| A5063 |
Drain ostomy pouch w/flange |
129 |
129 |
$20K |
| T4532 |
Ped size pull-on lg |
86 |
79 |
$19K |
| E0971 |
Wheelchair anti-tipping devi |
2,050 |
1,965 |
$19K |
| E0978 |
W/c acc,saf belt pelv strap |
4,445 |
4,006 |
$19K |
| E1236 |
Folding ped wc adjustable |
85 |
85 |
$18K |
| A4595 |
Tens suppl 2 lead per month |
510 |
501 |
$17K |
| T4537 |
Reusable underpad bed size |
507 |
506 |
$16K |
| A4419 |
Ost pch for bar w flange/flt |
116 |
114 |
$16K |
| A4333 |
Urinary cath anchor device |
243 |
239 |
$16K |
| A6197 |
Alginate drsg >16 <=48 sq in |
28 |
28 |
$16K |
| A4371 |
Skin barrier powder per oz |
2,293 |
2,265 |
$15K |
| E0250 |
Hosp bed fixed ht w/ mattres |
1,041 |
1,039 |
$13K |
| B4149 |
Ef blenderized foods |
12 |
12 |
$13K |
| A6446 |
Conform band s w>=3" <5"/yd |
167 |
163 |
$12K |
| E0482 |
Cough stimulating device |
25 |
25 |
$12K |
| A4332 |
Lube sterile packet |
546 |
523 |
$11K |
| A7509 |
Heat & moisture exchange sys |
103 |
101 |
$10K |
| L3000 |
Ft insert ucb berkeley shell |
19 |
19 |
$9K |
| L0650 |
Lso sc r ant/pos pnl pre ots |
12 |
12 |
$9K |
| A6216 |
Non-sterile gauze<=16 sq in |
484 |
474 |
$9K |
| A7015 |
Aerosol mask used w nebulize |
4,221 |
4,106 |
$9K |
| A7525 |
Tracheostomy mask |
503 |
494 |
$8K |
| B4036 |
Enteral feed sup kit grav by |
114 |
91 |
$8K |
| E0114 |
Crutch underarm pair no wood |
215 |
214 |
$8K |
| A7046 |
Repl water chamber, pap dev |
410 |
409 |
$6K |
| A4424 |
Ost pch drain w bar & filter |
13 |
13 |
$4K |
| L8501 |
Tracheostomy speaking valve |
52 |
50 |
$4K |
| E0310 |
Rails bed side full length |
178 |
175 |
$3K |
| E0181 |
Press pad alternating w/ pum |
236 |
232 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
73 |
71 |
$3K |
| K0002 |
Stnd hemi (low seat) whlchr |
37 |
37 |
$2K |
| A5061 |
Pouch drainable w barrier at |
12 |
12 |
$2K |
| T4529 |
Ped size brief/diaper sm/med |
18 |
13 |
$2K |
| A7003 |
Nebulizer administration set |
755 |
752 |
$2K |
| A7001 |
Nondisposable pump canister |
33 |
33 |
$2K |
| E0241 |
Bath tub wall rail |
65 |
63 |
$1K |
| E0165 |
Commode chair with detacharm |
12 |
12 |
$1K |
| A4455 |
Adhesive remover per ounce |
64 |
64 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
51 |
50 |
$867.50 |
| A4369 |
Skin barrier liquid per oz |
25 |
25 |
$820.92 |
| T4536 |
Reusable pull-on any size |
56 |
45 |
$759.73 |
| A6219 |
Gauze <= 16 sq in w/border |
12 |
12 |
$595.00 |
| A4331 |
Extension drainage tubing |
37 |
36 |
$574.20 |
| A4421 |
Ostomy supply misc |
12 |
12 |
$289.67 |
| A4450 |
Non-waterproof tape |
13 |
13 |
$7.30 |
| S9999 |
Sales tax |
456 |
446 |
$0.00 |