| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2275 |
Plastic mod low ext pad/line |
260,201 |
137,546 |
$20.92M |
| A4554 |
Disposable underpads |
546,627 |
540,936 |
$16.72M |
| A4575 |
Hyperbaric o2 chamber disps |
2,557 |
2,476 |
$15.08M |
| L3010 |
Foot longitudinal arch suppo |
175,192 |
90,798 |
$14.91M |
| E0466 |
Home vent non-invasive inter |
19,825 |
19,596 |
$14.54M |
| T4523 |
Adult size brief/diaper lg |
243,820 |
241,021 |
$13.35M |
| A9276 |
Disposable sensor, cgm sys |
41,835 |
41,677 |
$11.16M |
| L3030 |
Foot arch support remov prem |
177,461 |
93,927 |
$10.72M |
| L3001 |
Foot insert remov molded spe |
116,163 |
58,420 |
$10.30M |
| T4535 |
Disposable liner/shield/pad |
462,509 |
455,018 |
$10.28M |
| E0603 |
Electric breast pump |
61,980 |
60,579 |
$9.53M |
| T4524 |
Adult size brief/diaper xl |
120,763 |
119,079 |
$9.14M |
| T4522 |
Adult size brief/diaper med |
207,428 |
205,254 |
$8.51M |
| L3000 |
Ft insert ucb berkeley shell |
38,206 |
23,258 |
$8.29M |
| E1399 |
Durable medical equipment mi |
25,161 |
22,984 |
$8.18M |
| E0465 |
Home vent invasive interface |
9,656 |
9,139 |
$8.15M |
| L3215 |
Orthopedic ftwear ladies oxf |
116,699 |
61,627 |
$7.65M |
| B4161 |
Ef ped hydrolyzed/amino acid |
10,995 |
10,682 |
$6.87M |
| L1971 |
Afo w/ankle joint, prefab |
29,302 |
16,213 |
$6.67M |
| E0483 |
Hi freq chest wall oscil sys |
24,268 |
23,729 |
$6.59M |
| E1390 |
Oxygen concentrator |
93,214 |
91,045 |
$6.35M |
| A9277 |
External transmitter, cgm |
13,875 |
13,825 |
$6.28M |
| T4543 |
Adult disp brief/diap abv xl |
35,774 |
35,219 |
$5.51M |
| L3219 |
Orthopedic mens shoes oxford |
76,088 |
39,815 |
$5.33M |
| T4537 |
Reusable underpad bed size |
200,312 |
198,458 |
$4.68M |
| E0601 |
Cont airway pressure device |
119,830 |
118,662 |
$4.63M |
| L0648 |
Lso sag r an/pos pnl pre ots |
9,364 |
9,354 |
$4.49M |
| L1833 |
Ko adj jnt pos r sup pre ots |
11,924 |
7,933 |
$4.30M |
| S5161 |
Emer rspns sys serv permonth |
78,770 |
77,840 |
$4.05M |
| L3020 |
Foot longitud/metatarsal sup |
32,792 |
20,169 |
$3.99M |
| L3410 |
Shoe metatarsal bar between |
70,761 |
36,269 |
$3.82M |
| L3216 |
Orthoped ladies shoes dpth i |
88,383 |
47,740 |
$3.67M |
| T4539 |
Reuse diaper/brief any size |
142,904 |
141,740 |
$3.24M |
| L3202 |
Oxford w/ supinat/pronator c |
82,393 |
43,005 |
$3.24M |
| L3217 |
Ladies shoes hightop depth i |
41,709 |
22,239 |
$3.19M |
| L3480 |
Shoe heel pad & depress for |
159,139 |
81,646 |
$3.12M |
| B4150 |
Ef complet w/intact nutrient |
33,794 |
33,126 |
$2.78M |
| L3221 |
Orthopedic mens shoes dpth i |
53,888 |
28,917 |
$2.77M |
| L0650 |
Lso sc r ant/pos pnl pre ots |
4,664 |
4,648 |
$2.57M |
| B4154 |
Ef spec metabolic noninherit |
23,072 |
22,734 |
$2.55M |
| A4353 |
Intermittent urinary cath |
11,588 |
11,207 |
$2.54M |
| E0575 |
Nebulizer ultrasonic |
10,959 |
10,938 |
$2.52M |
| E0445 |
Oximeter non-invasive |
14,400 |
14,262 |
$2.49M |
| B4158 |
Ef ped complete intact nut |
6,141 |
5,902 |
$2.45M |
| E0570 |
Nebulizer with compression |
51,620 |
51,076 |
$2.38M |
| L0642 |
Lo sag ri an/pos pnl pre ots |
11,109 |
11,094 |
$2.24M |
| L3807 |
Whfo w/o joints pre cst |
15,543 |
9,123 |
$2.09M |
| K0553 |
Ther cgm supply allowance |
14,672 |
14,458 |
$2.07M |
| L3809 |
Whfo w/o joints pre ots |
17,093 |
9,629 |
$2.05M |
| L2630 |
Pelvic control band & belt u |
9,260 |
9,228 |
$1.87M |
| L3002 |
Foot insert plastazote or eq |
18,816 |
10,207 |
$1.82M |
| L3222 |
Mens shoes hightop depth inl |
20,189 |
10,853 |
$1.81M |
| L1832 |
Ko adj jnt pos r sup pre cst |
3,961 |
2,707 |
$1.79M |
| E0562 |
Humidifier heated used w pap |
36,802 |
36,606 |
$1.77M |
| A6539 |
Gc stocking waistlngth 18-30 |
11,433 |
8,982 |
$1.73M |
| A7030 |
Cpap full face mask |
20,090 |
19,748 |
$1.66M |
| L1820 |
Ko elas w/ condyle pads & jo |
22,264 |
12,686 |
$1.65M |
| B4035 |
Enteral feed supp pump per d |
11,011 |
10,270 |
$1.64M |
| T4521 |
Adult size brief/diaper sm |
32,532 |
32,141 |
$1.59M |
| T4527 |
Adult size pull-on lg |
35,051 |
33,623 |
$1.56M |
| K0739 |
Repair/svc dme non-oxygen eq |
43,901 |
42,544 |
$1.54M |
| S1040 |
Cranial remolding orthosis |
866 |
832 |
$1.51M |
| K0823 |
Pwc gp 2 std cap chair |
8,040 |
7,983 |
$1.49M |
| T4526 |
Adult size pull-on med |
38,557 |
36,832 |
$1.48M |
| A4351 |
Straight tip urine catheter |
16,605 |
16,079 |
$1.36M |
| L2114 |
Afo tib fx semi-rigid |
4,774 |
4,723 |
$1.34M |
| T4540 |
Reusable underpad chair size |
75,816 |
75,313 |
$1.32M |
| A4927 |
Non-sterile gloves |
276,862 |
268,771 |
$1.31M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
5,753 |
5,577 |
$1.26M |
| A4624 |
Tracheal suction tube |
5,597 |
5,360 |
$1.24M |
| A5500 |
Diab shoe for density insert |
27,569 |
15,748 |
$1.21M |
| E0482 |
Cough stimulating device |
7,141 |
7,026 |
$1.21M |
| E0143 |
Walker folding wheeled w/o s |
31,610 |
31,304 |
$1.17M |
| A4520 |
Incontinence garment anytype |
13,308 |
12,236 |
$1.14M |
| L0627 |
Lo sag ri an/pos pnl pre cst |
4,911 |
4,900 |
$1.12M |
| A4239 |
Non-adju cgm supply allow |
17,567 |
17,303 |
$1.10M |
| A6530 |
Compression stocking bk18-30 |
30,828 |
17,427 |
$1.09M |
| A6540 |
Gc stocking waistlngth 30-40 |
5,084 |
4,164 |
$1.09M |
| L1970 |
Afo plastic molded w/ankle j |
1,773 |
1,155 |
$1.05M |
| A6023 |
Collagen dressing >48 sq in |
1,800 |
1,777 |
$1.04M |
| A4335 |
Incontinence supply |
38,270 |
36,301 |
$1000K |
| L2820 |
Soft interface below knee se |
13,064 |
9,196 |
$990K |
| T4533 |
Youth size brief/diaper |
12,702 |
12,554 |
$946K |
| K0001 |
Standard wheelchair |
56,000 |
55,518 |
$936K |
| L3206 |
Hightop w/ supp/pronator chi |
26,903 |
13,724 |
$933K |
| L3485 |
Shoe heel pad removable for |
31,922 |
16,354 |
$904K |
| L2112 |
Afo tibial fracture soft |
3,307 |
3,291 |
$897K |
| E0431 |
Portable gaseous 02 |
55,950 |
54,869 |
$888K |
| A6247 |
Hydrogel drg > 48 sq in w/b |
2,648 |
2,618 |
$884K |
| L3430 |
Sho heel count plast reinfor |
8,822 |
4,562 |
$871K |
| B9998 |
Enteral supp not otherwise c |
2,432 |
2,253 |
$825K |
| B4152 |
Ef calorie dense>/=1.5kcal |
10,358 |
10,116 |
$818K |
| L3230 |
Custom shoes depth inlay |
3,769 |
1,880 |
$794K |
| A4253 |
Blood glucose/reagent strips |
81,323 |
80,593 |
$794K |
| E0240 |
Bath/shower chair |
31,643 |
31,396 |
$788K |
| L1906 |
Afo multilig ank sup pre ots |
14,645 |
7,783 |
$772K |
| A4670 |
Automatic bp monitor, dial |
25,006 |
24,829 |
$767K |
| A7034 |
Nasal application device |
20,720 |
20,393 |
$766K |
| T4528 |
Adult size pull-on xl |
15,038 |
14,200 |
$759K |
| E0470 |
Rad w/o backup non-inv intfc |
6,856 |
6,770 |
$734K |
| L1960 |
Afo pos solid ank plastic mo |
1,220 |
814 |
$719K |
| B4153 |
Ef hydrolyzed/amino acids |
764 |
760 |
$710K |
| L0621 |
Sio flex pelvic/sacr pre ots |
11,011 |
10,866 |
$710K |
| L3390 |
Shoe outflare wedge |
25,899 |
13,203 |
$708K |
| E1815 |
Adjust ankle ext & flex dev |
2,015 |
1,502 |
$699K |
| A4230 |
Infus insulin pump non needl |
3,607 |
3,569 |
$694K |
| A6244 |
Hydrogel drg >48 in w/o bdr |
2,528 |
2,509 |
$655K |
| T4541 |
Large disposable underpad |
24,929 |
23,041 |
$654K |
| A5512 |
Multi den insert direct form |
17,239 |
9,885 |
$644K |
| L3916 |
Who nontorsion jnts pre ots |
2,484 |
1,639 |
$624K |
| L0631 |
Lso sag r an/pos pnl pre cst |
1,130 |
1,127 |
$616K |
| A7031 |
Replacement facemask interfa |
14,294 |
14,143 |
$610K |
| K0108 |
W/c component-accessory nos |
3,073 |
992 |
$554K |
| A9278 |
External receiver, cgm sys |
2,364 |
2,359 |
$548K |
| L2280 |
Molded inner boot |
1,450 |
905 |
$487K |
| L3360 |
Shoe sole wedge outside sole |
22,349 |
11,171 |
$477K |
| E0261 |
Hosp bed semi-electr w/o mat |
11,086 |
11,001 |
$471K |
| E0241 |
Bath tub wall rail |
20,843 |
20,665 |
$467K |
| A7035 |
Pos airway press headgear |
34,078 |
33,703 |
$451K |
| L3710 |
Eo elas w/metal jnts pre ots |
7,993 |
4,297 |
$447K |
| A6197 |
Alginate drsg >16 <=48 sq in |
2,689 |
2,640 |
$438K |
| E0652 |
Pneum compres w/cal pressure |
917 |
917 |
$433K |
| L3170 |
Foot plas heel stabi pre ots |
14,063 |
7,027 |
$433K |
| E0990 |
Wheelchair elevating leg res |
24,773 |
18,812 |
$428K |
| A4629 |
Tracheostomy care kit |
4,709 |
4,619 |
$422K |
| E2611 |
Gen use back cush wdth <22in |
3,821 |
3,792 |
$418K |
| A4385 |
Ost skn barrier sld ext wear |
6,243 |
5,953 |
$417K |
| A6236 |
Hydrocolld drg > 48 in w/o b |
1,935 |
1,917 |
$412K |
| A4352 |
Coude tip urinary catheter |
1,760 |
1,713 |
$409K |
| L1907 |
Afo supramalleolar custom |
981 |
557 |
$405K |
| B9002 |
Enter nutr inf pump any type |
3,140 |
3,098 |
$405K |
| L4396 |
Static or dynami afo pre cst |
3,296 |
2,110 |
$404K |
| L5673 |
Socket insert w lock mech |
742 |
660 |
$400K |
| L3050 |
Foot arch supp premold metat |
12,810 |
6,665 |
$385K |
| E0163 |
Commode chair with fixed arm |
9,701 |
9,561 |
$375K |
| L3450 |
Shoe heel sach cushion type |
4,739 |
2,794 |
$368K |
| L3908 |
Who cock-up nonmolde pre ots |
9,713 |
8,319 |
$367K |
| L3203 |
Oxford w/ supinator/pronator |
8,905 |
4,616 |
$366K |
| A5513 |
Multi den insert custom mold |
6,651 |
3,757 |
$365K |
| L1930 |
Afo plastic |
2,347 |
1,426 |
$360K |
| E0277 |
Powered pres-redu air mattrs |
1,944 |
1,910 |
$350K |
| L0637 |
Lso sc r ant/pos pnl pre cst |
749 |
743 |
$348K |
| L3003 |
Foot insert silicone gel eac |
3,957 |
1,984 |
$347K |
| L3040 |
Ft arch suprt premold longit |
7,518 |
3,796 |
$347K |
| A7032 |
Replacement nasal cushion |
10,010 |
9,937 |
$341K |
| A7037 |
Pos airway pressure tubing |
32,683 |
32,531 |
$335K |
| K0003 |
Lightweight wheelchair |
8,484 |
8,408 |
$335K |
| A4605 |
Trach suction cath close sys |
2,368 |
2,306 |
$335K |
| T4530 |
Ped size brief/diaper lg |
6,673 |
6,538 |
$334K |
| L3310 |
Shoe lift elev heel/sole neo |
5,845 |
3,032 |
$330K |
| L2755 |
Carbon graphite lamination |
6,023 |
3,287 |
$322K |
| A7526 |
Tracheostomy tube collar |
4,307 |
4,194 |
$312K |
| T4544 |
Adlt disp und/pull on abv xl |
2,142 |
1,936 |
$309K |
| E0260 |
Hosp bed semi-electr w/ matt |
18,592 |
18,304 |
$308K |
| E1392 |
Portable oxygen concentrator |
9,853 |
9,764 |
$281K |
| E0748 |
Elec osteogen stim spinal |
119 |
118 |
$273K |
| A4402 |
Lubricant per ounce |
31,239 |
30,313 |
$272K |
| A7005 |
Nondisposable nebulizer set |
19,657 |
19,461 |
$257K |
| A4409 |
Ost skn barr convex <=4 sq i |
4,732 |
4,531 |
$244K |
| E0630 |
Patient lift hydraulic |
6,451 |
6,404 |
$233K |
| L3207 |
Hightop w/ supp/pronator jun |
7,006 |
3,502 |
$232K |
| A7520 |
Trach/laryn tube non-cuffed |
5,459 |
5,115 |
$229K |
| A4224 |
Supply insulin inf cath/wk |
1,894 |
1,831 |
$225K |
| A6533 |
Gc stocking thighlngth 18-30 |
3,929 |
2,770 |
$220K |
| A4238 |
Adju cgm supply allowance |
2,299 |
2,255 |
$212K |
| A7507 |
Integrated filter & holder |
3,177 |
3,079 |
$210K |
| E0973 |
W/ch access det adj armrest |
4,189 |
2,847 |
$209K |
| E0667 |
Seg pneumatic appl full leg |
984 |
545 |
$205K |
| E0600 |
Suction pump portab hom modl |
6,143 |
6,097 |
$197K |
| E0243 |
Toilet rail |
6,214 |
6,166 |
$192K |
| E0156 |
Walker seat attachment |
22,584 |
22,356 |
$191K |
| B4155 |
Ef incomplete/modular |
765 |
724 |
$190K |
| A4400 |
Ostomy irrigation set |
690 |
681 |
$186K |
| T4525 |
Adult size pull-on sm |
5,335 |
5,124 |
$183K |
| E0247 |
Trans bench w/wo comm open |
3,225 |
3,196 |
$179K |
| S8101 |
Spacer with mask |
6,354 |
6,298 |
$176K |
| E0651 |
Pneum compressor segmental |
319 |
319 |
$171K |
| L3340 |
Shoe wedge sach |
5,274 |
2,651 |
$171K |
| A4425 |
Ost pch drain for barrier fl |
3,451 |
3,293 |
$170K |
| L3915 |
Who nontorsion jnts pre cst |
618 |
355 |
$167K |
| L2840 |
Tibial length sock fx or equ |
3,443 |
2,643 |
$166K |
| L5671 |
Bk/ak locking mechanism |
500 |
448 |
$165K |
| B4162 |
Ef ped specmetabolic inherit |
195 |
184 |
$164K |
| E0784 |
Ext amb infusn pump insulin |
42 |
42 |
$164K |
| L5301 |
Bk mold socket sach ft endo |
133 |
118 |
$164K |
| A7000 |
Disposable canister for pump |
9,822 |
9,397 |
$162K |
| A4362 |
Solid skin barrier |
3,514 |
3,357 |
$161K |
| A4407 |
Ext wear ost skn barr <=4sq" |
2,044 |
1,961 |
$159K |
| E0971 |
Wheelchair anti-tipping devi |
6,006 |
4,475 |
$156K |
| A4604 |
Tubing with heating element |
6,807 |
6,332 |
$154K |
| L3060 |
Foot arch supp longitud/meta |
4,510 |
2,477 |
$154K |
| A6198 |
Alginate dressing > 48 sq in |
1,552 |
1,536 |
$151K |
| L5940 |
Endo bk ultra-light material |
422 |
371 |
$148K |
| L3808 |
Whfo, rigid w/o joints |
583 |
359 |
$145K |
| A7038 |
Pos airway pressure filter |
39,159 |
38,609 |
$143K |
| A5057 |
1 pc ost pou w built-in conv |
1,113 |
1,103 |
$143K |
| A4287 |
Disp col sto bag breast milk |
1,739 |
1,714 |
$143K |
| K1005 |
Disp col sto bag breast milk |
2,125 |
2,093 |
$142K |
| L3760 |
Eo adj jt prefab custom fit |
852 |
436 |
$141K |
| L5645 |
Bk flex inner socket ext fra |
409 |
368 |
$141K |
| L5620 |
Test socket below knee |
640 |
564 |
$141K |
| L5637 |
Below knee total contact |
597 |
531 |
$141K |
| L0649 |
Lso sc r pos/lat pnl pre ots |
974 |
833 |
$138K |
| L3400 |
Shoe metatarsal bar wedge ro |
5,480 |
2,741 |
$133K |
| A6021 |
Collagen dressing <=16 sq in |
1,684 |
1,656 |
$129K |
| A6402 |
Sterile gauze <= 16 sq in |
14,789 |
14,362 |
$128K |
| A4259 |
Lancets per box |
76,403 |
75,807 |
$127K |
| K0554 |
Ther cgm receiver/monitor |
936 |
926 |
$124K |
| A5120 |
Skin barrier, wipe or swab |
19,549 |
18,410 |
$124K |
| E0244 |
Toilet seat raised |
9,977 |
9,859 |
$123K |
| A5063 |
Drain ostomy pouch w/flange |
3,538 |
3,393 |
$123K |
| L4361 |
Pneuma/vac walk boot pre ots |
540 |
526 |
$118K |
| L5679 |
Socket insert w/o lock mech |
224 |
191 |
$117K |
| E2601 |
Gen w/c cushion wdth < 22 in |
5,025 |
4,980 |
$116K |
| L3702 |
Eo w/o joints cf |
622 |
341 |
$114K |
| L3960 |
Sewho airplan desig abdu pos |
442 |
441 |
$113K |
| A4225 |
Sup/ext insulin inf pump syr |
2,968 |
2,874 |
$113K |
| E0580 |
Nebulizer for use w/ regulat |
1,421 |
1,412 |
$112K |
| K0006 |
Heavy duty wheelchair |
1,881 |
1,873 |
$110K |
| L5629 |
Below knee acrylic socket |
490 |
434 |
$110K |
| T4534 |
Youth size pull-on |
1,323 |
1,213 |
$109K |
| A5122 |
Solid skin barrier 8x8 |
912 |
909 |
$103K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
1,818 |
1,765 |
$102K |
| A6212 |
Foam drg <=16 sq in w/border |
1,317 |
1,214 |
$101K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
1,719 |
1,639 |
$101K |
| A4378 |
Drainable rubber pch w/o fp |
414 |
404 |
$100K |
| L5910 |
Endo below knee alignable sy |
433 |
383 |
$98K |
| E0607 |
Blood glucose monitor home |
3,115 |
3,089 |
$98K |
| A4217 |
Sterile water/saline, 500 ml |
7,747 |
7,589 |
$96K |
| A4357 |
Bedside drainage bag |
4,714 |
4,526 |
$93K |
| E0978 |
W/c acc,saf belt pelv strap |
6,106 |
6,017 |
$91K |
| S5160 |
Emer response sys instal&tst |
1,469 |
1,424 |
$86K |
| A4606 |
Oxygen probe used w oximeter |
1,142 |
610 |
$86K |
| A7033 |
Replacement nasal pillows |
2,806 |
2,709 |
$86K |
| A4216 |
Sterile water/saline, 10 ml |
6,719 |
6,568 |
$86K |
| K0738 |
Portable gas oxygen system |
5,763 |
5,680 |
$84K |
| A4595 |
Tens suppl 2 lead per month |
3,042 |
2,793 |
$83K |
| E1028 |
W/c manual swingaway |
382 |
274 |
$83K |
| L3995 |
Sock fracture or equal each |
1,729 |
1,551 |
$82K |
| B4034 |
Enter feed supkit syr by day |
1,013 |
939 |
$80K |
| A9999 |
Dme supply or accessory, nos |
7,637 |
4,904 |
$79K |
| K0195 |
Elevating whlchair leg rests |
26,276 |
25,966 |
$78K |
| L2116 |
Afo tibial fracture rigid |
214 |
214 |
$73K |
| A4349 |
Disposable male external cat |
1,327 |
1,257 |
$71K |
| K0848 |
Pwc gp 3 std seat/back |
179 |
178 |
$71K |
| L1810 |
Ko elastic with joints |
1,096 |
613 |
$70K |
| L1910 |
Afo sing bar clasp attach sh |
531 |
288 |
$70K |
| K0824 |
Pwc gp 2 hd seat/back |
544 |
542 |
$70K |
| E0147 |
Walker variable wheel resist |
602 |
580 |
$70K |
| E0190 |
Positioning cushion |
3,711 |
3,700 |
$69K |
| L2270 |
Varus/valgus strap padded/li |
2,339 |
1,389 |
$69K |
| L1902 |
Afo ankle gauntlet pre ots |
1,764 |
1,655 |
$68K |
| A4232 |
Syringe w/needle insulin 3cc |
1,279 |
1,238 |
$68K |
| E0149 |
Heavy duty wheeled walker |
1,321 |
1,313 |
$67K |
| A4628 |
Oropharyngeal suction cath |
6,132 |
5,957 |
$65K |
| L3320 |
Shoe lift elev heel/sole cor |
1,407 |
772 |
$65K |
| L2250 |
Foot plate molded stirrup at |
274 |
172 |
$64K |
| L1851 |
Ko single upright prefab ots |
249 |
202 |
$63K |
| A6196 |
Alginate dressing <=16 sq in |
518 |
494 |
$63K |
| A4358 |
Urinary leg or abdomen bag |
2,807 |
2,679 |
$62K |
| A7002 |
Tubing used w suction pump |
9,417 |
9,270 |
$62K |
| E0855 |
Cervical traction equipment |
160 |
160 |
$62K |
| E0114 |
Crutch underarm pair no wood |
2,537 |
2,445 |
$60K |
| A4245 |
Alcohol wipes per box |
70,419 |
69,984 |
$59K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
520 |
509 |
$58K |
| L3332 |
Shoe lifts tapered to one-ha |
1,190 |
819 |
$58K |
| L5704 |
Custom shape cover bk |
151 |
134 |
$56K |
| E0955 |
Cushioned headrest |
536 |
511 |
$55K |
| L3031 |
Foot lamin/prepreg composite |
807 |
402 |
$53K |
| L3224 |
Woman's shoe oxford brace |
1,247 |
629 |
$53K |
| L1843 |
Ko single upright pre cst |
98 |
95 |
$52K |
| A4556 |
Electrodes, pair |
3,591 |
3,549 |
$52K |
| E2361 |
22nf sealed leadacid battery |
779 |
768 |
$52K |
| L3370 |
Shoe sole wedge between sole |
1,571 |
1,056 |
$52K |
| E0565 |
Compressor air power source |
1,684 |
1,683 |
$50K |
| L3962 |
Sewho erbs palsey design abd |
120 |
120 |
$50K |
| A4394 |
Ostomy pouch liq deodorant |
2,784 |
2,700 |
$49K |
| A4456 |
Adhesive remover, wipes |
6,528 |
6,264 |
$49K |
| L2397 |
Suspension sleeve lower ext |
1,419 |
998 |
$48K |
| A6446 |
Conform band s w>=3" <5"/yd |
3,270 |
3,159 |
$47K |
| E0100 |
Cane adjust/fixed with tip |
7,493 |
7,407 |
$47K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,070 |
1,028 |
$47K |
| A4221 |
Supp non-insulin inf cath/wk |
680 |
671 |
$46K |
| L3660 |
So 8 ab rstr can/web pre ots |
721 |
688 |
$45K |
| E0271 |
Mattress innerspring |
705 |
699 |
$44K |
| B4100 |
Food thickener oral |
1,060 |
1,022 |
$43K |
| L1850 |
Ko swedish type pre ots |
258 |
172 |
$41K |
| L3982 |
Upper ext fx orthosis rad/ul |
140 |
137 |
$41K |
| E0604 |
Hosp grade elec breast pump |
781 |
749 |
$41K |
| L0180 |
Cer post col occ/man sup adj |
253 |
253 |
$40K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
972 |
921 |
$40K |
| K0002 |
Stnd hemi (low seat) whlchr |
1,980 |
1,939 |
$39K |
| E0961 |
Wheelchair brake extension |
2,128 |
1,838 |
$39K |
| L8420 |
Prosthetic sock multi ply bk |
536 |
476 |
$38K |
| A4452 |
Waterproof tape |
4,901 |
4,701 |
$38K |
| A7046 |
Repl water chamber, pap dev |
5,315 |
5,092 |
$37K |
| K0004 |
High strength ltwt whlchr |
387 |
387 |
$36K |
| L2780 |
Non-corrosive finish |
312 |
203 |
$36K |
| B4149 |
Ef blenderized foods |
79 |
72 |
$34K |
| A9274 |
Ext amb insulin delivery sys |
39 |
37 |
$34K |
| E0776 |
Iv pole |
904 |
876 |
$33K |
| L0624 |
Sio panel custom |
209 |
209 |
$32K |
| E0745 |
Neuromuscular stim for shock |
240 |
239 |
$31K |
| E1810 |
Adjust knee ext & flex dev |
90 |
68 |
$30K |
| E2103 |
Non-adju cgm receiver/mon |
716 |
704 |
$30K |
| E0561 |
Humidifier nonheated w pap |
4,132 |
4,113 |
$30K |
| E0656 |
Segmental pneumatic trunk |
843 |
843 |
$30K |
| L4350 |
Ankle control ortho pre ots |
358 |
326 |
$28K |
| A4310 |
Insert tray w/o bag/cath |
495 |
477 |
$27K |
| L3762 |
Eo rigid w/o joints pre ots |
492 |
248 |
$27K |
| E1226 |
Manual fully reclining back |
203 |
200 |
$26K |
| A7521 |
Trach/laryn tube cuffed |
614 |
541 |
$25K |
| L3670 |
So acro/clav can web pre ots |
276 |
274 |
$24K |
| L0651 |
Lso sag-co shell pnl pre ots |
51 |
51 |
$24K |
| L5986 |
Multi-axial rotation unit |
72 |
62 |
$24K |
| K0857 |
Pwc gp3 std sing pow opt cap |
37 |
37 |
$24K |
| E0730 |
Tens four lead |
887 |
879 |
$23K |
| L8000 |
Mastectomy bra |
296 |
276 |
$23K |
| A4432 |
Os pch urine w bar/fange/tap |
483 |
458 |
$23K |
| A5514 |
Mult den insert dir carv/cam |
615 |
314 |
$22K |
| A7003 |
Nebulizer administration set |
7,320 |
7,215 |
$22K |
| L8310 |
Truss double w/ standard pad |
242 |
237 |
$21K |
| A4623 |
Tracheostomy inner cannula |
291 |
263 |
$21K |
| L5685 |
Below knee sus/seal sleeve |
217 |
190 |
$21K |
| A7007 |
Lg vol nebulizer disposable |
7,476 |
3,683 |
$20K |
| L1830 |
Ko immob canvas long pre ots |
283 |
244 |
$20K |
| E0245 |
Tub stool or bench |
1,252 |
1,186 |
$20K |
| A4373 |
Skin barrier with flange |
239 |
238 |
$19K |
| L2210 |
Dorsiflexion assist each joi |
436 |
267 |
$19K |
| L1300 |
Body jacket mold to patient |
13 |
13 |
$19K |
| T4542 |
Small disposable underpad |
1,257 |
1,135 |
$18K |
| A7039 |
Filter, non disposable w pap |
8,227 |
8,170 |
$18K |
| E0135 |
Walker folding adjust/fixed |
183 |
183 |
$18K |
| E0274 |
Over-bed table |
473 |
468 |
$18K |
| A7525 |
Tracheostomy mask |
4,129 |
4,069 |
$18K |
| A4419 |
Ost pch for bar w flange/flt |
231 |
220 |
$17K |
| E0265 |
Hosp bed total electr w/ mat |
128 |
128 |
$17K |
| A4450 |
Non-waterproof tape |
3,220 |
3,111 |
$16K |
| E0105 |
Cane adjust/fixed quad/3 pro |
1,359 |
1,298 |
$16K |
| L3260 |
Ambulatory surgical boot eac |
1,195 |
1,130 |
$16K |
| A7036 |
Pos airway press chinstrap |
1,563 |
1,558 |
$16K |
| E0960 |
W/c shoulder harness/straps |
214 |
183 |
$16K |
| L2810 |
Knee control condylar pad |
154 |
139 |
$16K |
| L4397 |
Static or dynami afo pre ots |
161 |
81 |
$15K |
| A4406 |
Pectin based ostomy paste |
1,100 |
1,057 |
$14K |
| L3225 |
Man's shoe oxford brace |
328 |
164 |
$14K |
| L1940 |
Afo molded to patient plasti |
32 |
27 |
$14K |
| E0215 |
Electric heat pad moist |
563 |
561 |
$14K |
| E2402 |
Neg press wound therapy pump |
14 |
13 |
$14K |
| E0144 |
Enclosed walker w rear seat |
94 |
94 |
$13K |
| A4231 |
Infusion insulin pump needle |
98 |
97 |
$13K |
| A4481 |
Tracheostoma filter |
215 |
212 |
$13K |
| L2300 |
Abduction bar jointed adjust |
72 |
68 |
$13K |
| A6250 |
Skin seal protect moisturizr |
787 |
756 |
$13K |
| E0650 |
Pneuma compresor non-segment |
79 |
79 |
$13K |
| L5651 |
Ak flex inner socket ext fra |
25 |
25 |
$13K |
| A4371 |
Skin barrier powder per oz |
3,273 |
3,156 |
$12K |
| L2330 |
Lacer molded to patient mode |
34 |
17 |
$12K |
| L0628 |
Lso flex no ri stays pre ots |
228 |
226 |
$12K |
| L2220 |
Dorsi & plantar flex ass/res |
162 |
105 |
$12K |
| A4322 |
Irrigation syringe |
520 |
498 |
$12K |
| E0471 |
Rad w/backup non inv intrfc |
65 |
65 |
$11K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
62 |
60 |
$11K |
| A7015 |
Aerosol mask used w nebulize |
11,629 |
11,455 |
$11K |
| L2640 |
Pelvic control band & belt b |
39 |
39 |
$11K |
| E0303 |
Hosp bed hvy dty xtra wide |
410 |
409 |
$11K |
| A9901 |
Delivery/set up/dispensing |
490 |
484 |
$11K |
| L0641 |
Lo rig pos pnl l1-l5 pre ots |
246 |
246 |
$11K |
| A4384 |
Ostomy faceplt/silicone ring |
254 |
249 |
$11K |
| K0800 |
Pov group 1 std up to 300lbs |
39 |
39 |
$11K |
| L4360 |
Pneumat walking boot pre cst |
60 |
60 |
$10K |
| L5649 |
Isch containmt/narrow m-l so |
12 |
12 |
$10K |
| B4036 |
Enteral feed sup kit grav by |
344 |
335 |
$9K |
| A6216 |
Non-sterile gauze<=16 sq in |
2,414 |
2,287 |
$9K |
| K0040 |
Adjustable angle footplate |
101 |
79 |
$9K |
| E0246 |
Transfer tub rail attachment |
225 |
225 |
$9K |
| A4344 |
Cath indw foley 2 way silicn |
295 |
285 |
$9K |
| A6583 |
Grad com wrap w straps bk |
75 |
38 |
$9K |
| A7010 |
Disposable corrugated tubing |
1,005 |
997 |
$9K |
| A4256 |
Calibrator solution/chips |
1,862 |
1,806 |
$8K |
| E0248 |
Hdtrans bench w/wo comm open |
111 |
109 |
$8K |
| A4338 |
Indwelling catheter latex |
271 |
263 |
$8K |
| E1038 |
Transport chair pt wt<=300lb |
1,820 |
1,726 |
$8K |
| A4367 |
Ostomy belt |
1,492 |
1,452 |
$8K |
| A4455 |
Adhesive remover per ounce |
1,203 |
1,153 |
$8K |
| L1831 |
Knee orth pos locking joint |
56 |
31 |
$8K |
| E0301 |
Hd hosp bed, 350-600 lbs |
80 |
80 |
$6K |
| A7020 |
Interface, cough stim device |
436 |
425 |
$6K |
| A5501 |
Diabetic custom molded shoe |
54 |
43 |
$6K |
| A4630 |
Repl bat t.e.n.s. own by pt |
2,982 |
2,939 |
$6K |
| A6531 |
Compress stking bk30-40 surg |
121 |
78 |
$6K |
| A9900 |
Supply/accessory/service |
107 |
96 |
$6K |
| A6235 |
Hydrocolld drg >16<=48 w/o b |
28 |
27 |
$6K |
| A4332 |
Lube sterile packet |
678 |
631 |
$6K |
| L5647 |
Below knee suction socket |
13 |
13 |
$6K |
| A6534 |
Gc stocking thighlngth 30-40 |
103 |
99 |
$5K |
| K0806 |
Pov group 2 std up to 300lbs |
13 |
13 |
$5K |
| L2200 |
Limited ankle motion ea jnt |
136 |
72 |
$5K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
88 |
86 |
$5K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
27 |
25 |
$5K |
| A6550 |
Neg pres wound ther drsg set |
17 |
12 |
$5K |
| L8030 |
Breast prosthes w/o adhesive |
28 |
25 |
$5K |
| L1812 |
Ko elastic w/joints pre ots |
96 |
62 |
$5K |
| E0154 |
Walker platform attachment |
81 |
81 |
$5K |
| E0956 |
W/c lateral trunk/hip suppor |
34 |
28 |
$4K |
| K0007 |
Extra heavy duty wheelchair |
58 |
58 |
$4K |
| E2607 |
Skin pro/pos wc cus wd <22in |
19 |
13 |
$4K |
| L2768 |
Ortho sidebar disconnect |
61 |
32 |
$4K |
| L5650 |
Tot contact ak/knee disart s |
12 |
12 |
$4K |
| L8501 |
Tracheostomy speaking valve |
65 |
63 |
$4K |
| A4331 |
Extension drainage tubing |
207 |
205 |
$4K |
| A6207 |
Contact layer >16<= 48 sq in |
83 |
80 |
$4K |
| E2620 |
Wc planar back cush wd <22in |
15 |
14 |
$4K |
| E0185 |
Gel pressure mattress pad |
53 |
52 |
$4K |
| L3420 |
Full sole/heel wedge btween |
122 |
61 |
$4K |
| L0456 |
Tlso flex trnk sj-ss pre cst |
12 |
12 |
$3K |
| L3520 |
O shoe add felt w leath insl |
193 |
96 |
$3K |
| E0210 |
Electric heat pad standard |
459 |
459 |
$3K |
| A4258 |
Lancet device each |
2,157 |
2,147 |
$3K |
| E0168 |
Heavyduty/wide commode chair |
66 |
66 |
$3K |
| L8470 |
Pros sock single ply bk |
135 |
125 |
$3K |
| E0110 |
Crutch forearm pair |
55 |
55 |
$3K |
| A6449 |
Lt compres band >=3" <5"/yd |
88 |
87 |
$2K |
| B4082 |
Enteral ng tubing w/o stylet |
243 |
208 |
$2K |
| A4557 |
Lead wires, pair |
568 |
566 |
$2K |
| A4320 |
Irrigation tray |
79 |
79 |
$2K |
| E0181 |
Press pad alternating w/ pum |
265 |
265 |
$2K |
| A6403 |
Sterile gauze>16 <= 48 sq in |
69 |
65 |
$2K |
| E2366 |
Battery charger, single mode |
41 |
41 |
$2K |
| A6443 |
Conform band n/s w>=3"<5"/yd |
305 |
301 |
$2K |
| A6219 |
Gauze <= 16 sq in w/border |
82 |
79 |
$2K |
| L0623 |
Sio rig pnl pelv/sac pre ots |
15 |
13 |
$2K |
| B4087 |
Gastro/jejuno tube, std |
95 |
94 |
$2K |
| A5126 |
Disk/foam pad +or- adhesive |
79 |
76 |
$2K |
| E2363 |
Gr24 sealed leadacid battery |
13 |
13 |
$2K |
| L4210 |
Orth dev repair/repl minor p |
28 |
14 |
$2K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
28 |
26 |
$2K |
| L3070 |
Arch suprt att to sho longit |
63 |
32 |
$1K |
| L3150 |
Abduct rotation bar w/o shoe |
31 |
30 |
$1K |
| A5121 |
Solid skin barrier 6x6 |
16 |
14 |
$1K |
| E2367 |
Battery charger, dual mode |
12 |
12 |
$1K |
| E0550 |
Humidif extens supple w ippb |
13 |
13 |
$1K |
| A4930 |
Sterile, gloves per pair |
28 |
25 |
$1K |
| L0625 |
Lo flex l1-below l5 pre ots |
37 |
37 |
$1K |
| A7012 |
Nebulizer water collec devic |
297 |
294 |
$1K |
| L1240 |
Lumbar derotation pad |
16 |
12 |
$1K |
| E2397 |
Pwc acc, lith-based battery |
15 |
15 |
$985.33 |
| A6258 |
Transparent film >16<=48 in |
27 |
24 |
$969.84 |
| A4369 |
Skin barrier liquid per oz |
344 |
317 |
$945.46 |
| L8440 |
Shrinker below knee |
17 |
12 |
$922.98 |
| T4532 |
Ped size pull-on lg |
17 |
14 |
$921.48 |
| A4614 |
Hand-held pefr meter |
42 |
42 |
$722.82 |
| B4081 |
Enteral ng tubing w/ stylet |
56 |
53 |
$643.11 |
| E0165 |
Commode chair with detacharm |
84 |
84 |
$629.46 |
| E0305 |
Rails bed side half length |
26 |
26 |
$596.34 |
| L0984 |
Protect body sock ea pre ots |
13 |
13 |
$587.90 |
| T4529 |
Ped size brief/diaper sm/med |
13 |
13 |
$452.30 |
| A6454 |
Self-adher band w>=3" <5"/yd |
27 |
25 |
$418.38 |
| B4102 |
Ef adult fluids and electro |
12 |
12 |
$401.63 |
| E0315 |
Bed accessory brd/tbl/supprt |
12 |
12 |
$362.09 |
| E0159 |
Brake for wheeled walker |
97 |
60 |
$309.10 |
| A4565 |
Slings |
58 |
57 |
$270.84 |
| E0605 |
Vaporizer room type |
24 |
24 |
$240.90 |
| E0325 |
Urinal male jug-type |
112 |
112 |
$197.59 |
| A7013 |
Disposable compressor filter |
501 |
496 |
$138.60 |
| A4618 |
Breathing circuits |
30 |
29 |
$112.89 |
| A7527 |
Trach/laryn tube plug/stop |
25 |
25 |
$90.24 |
| A6257 |
Transparent film <= 16 sq in |
55 |
55 |
$30.42 |
| E0235 |
Paraffin bath unit portable |
29 |
25 |
$13.59 |
| A7045 |
Repl exhalation port for pap |
13 |
13 |
$7.87 |
| A4931 |
Reusable oral thermometer |
14 |
14 |
$5.01 |
| A4510 |
Full length surg stocking |
108 |
28 |
$0.00 |
| 99080 |
|
4,290 |
2,559 |
$0.00 |