| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
138,916 |
126,584 |
$7.64M |
| E0601 |
Cont airway pressure device |
109,353 |
102,096 |
$5.53M |
| E0470 |
Rad w/o backup non-inv intfc |
18,224 |
17,080 |
$2.20M |
| E0466 |
Home vent non-invasive inter |
3,500 |
3,224 |
$2.01M |
| E0562 |
Humidifier heated used w pap |
25,780 |
23,065 |
$1.73M |
| A7030 |
Cpap full face mask |
28,266 |
24,605 |
$1.47M |
| A4604 |
Tubing with heating element |
41,267 |
36,463 |
$967K |
| E0431 |
Portable gaseous 02 |
41,408 |
38,953 |
$931K |
| K0738 |
Portable gas oxygen system |
38,138 |
34,124 |
$782K |
| E0570 |
Nebulizer with compression |
30,858 |
28,035 |
$760K |
| A7034 |
Nasal application device |
23,029 |
20,374 |
$752K |
| E0260 |
Hosp bed semi-electr w/ matt |
16,722 |
15,300 |
$711K |
| E0603 |
Electric breast pump |
6,221 |
6,186 |
$703K |
| E1392 |
Portable oxygen concentrator |
40,787 |
37,086 |
$696K |
| K0001 |
Standard wheelchair |
22,686 |
20,871 |
$643K |
| A7031 |
Replacement facemask interfa |
23,646 |
20,020 |
$621K |
| A7035 |
Pos airway press headgear |
34,962 |
31,460 |
$596K |
| A4239 |
Non-adju cgm supply allow |
5,387 |
4,619 |
$551K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,190 |
858 |
$494K |
| E0471 |
Rad w/backup non inv intrfc |
2,399 |
2,210 |
$459K |
| E0143 |
Walker folding wheeled w/o s |
9,319 |
8,429 |
$360K |
| B4035 |
Enteral feed supp pump per d |
2,899 |
2,044 |
$313K |
| A9276 |
Disposable sensor, cgm sys |
1,212 |
1,056 |
$276K |
| A7032 |
Replacement nasal cushion |
10,896 |
9,380 |
$269K |
| K0007 |
Extra heavy duty wheelchair |
2,280 |
2,070 |
$253K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,904 |
1,396 |
$239K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,754 |
1,328 |
$205K |
| A7033 |
Replacement nasal pillows |
9,059 |
7,817 |
$200K |
| A7038 |
Pos airway pressure filter |
65,460 |
56,707 |
$174K |
| K0553 |
Ther cgm supply allowance |
1,473 |
1,400 |
$167K |
| E0630 |
Patient lift hydraulic |
3,283 |
2,938 |
$167K |
| B4150 |
Ef complet w/intact nutrient |
1,585 |
1,198 |
$143K |
| E0303 |
Hosp bed hvy dty xtra wide |
1,387 |
1,309 |
$132K |
| K0006 |
Heavy duty wheelchair |
1,785 |
1,639 |
$126K |
| A7005 |
Nondisposable nebulizer set |
8,856 |
8,151 |
$113K |
| T4528 |
Adult size pull-on xl |
1,259 |
1,119 |
$111K |
| E0114 |
Crutch underarm pair no wood |
4,168 |
4,017 |
$107K |
| K0003 |
Lightweight wheelchair |
2,479 |
2,367 |
$105K |
| A7037 |
Pos airway pressure tubing |
6,928 |
6,194 |
$97K |
| B9998 |
Enteral supp not otherwise c |
2,301 |
1,423 |
$80K |
| T4541 |
Large disposable underpad |
2,370 |
2,102 |
$74K |
| B4153 |
Ef hydrolyzed/amino acids |
241 |
150 |
$73K |
| A9277 |
External transmitter, cgm |
245 |
221 |
$64K |
| E0600 |
Suction pump portab hom modl |
1,393 |
1,254 |
$63K |
| T4527 |
Adult size pull-on lg |
835 |
759 |
$62K |
| E0255 |
Hospital bed var ht w/ mattr |
3,941 |
3,391 |
$62K |
| B4034 |
Enter feed supkit syr by day |
1,195 |
938 |
$59K |
| A7046 |
Repl water chamber, pap dev |
15,935 |
13,697 |
$57K |
| B9002 |
Enter nutr inf pump any type |
1,273 |
1,098 |
$56K |
| T4526 |
Adult size pull-on med |
761 |
674 |
$53K |
| E0245 |
Tub stool or bench |
1,877 |
1,682 |
$51K |
| A4623 |
Tracheostomy inner cannula |
876 |
732 |
$51K |
| E0149 |
Heavy duty wheeled walker |
2,099 |
1,877 |
$51K |
| B4088 |
Gastro/jejuno tube, low-pro |
854 |
675 |
$51K |
| L4360 |
Pneumat walking boot pre cst |
363 |
356 |
$50K |
| B4149 |
Ef blenderized foods |
177 |
145 |
$48K |
| E0248 |
Hdtrans bench w/wo comm open |
747 |
649 |
$48K |
| T4535 |
Disposable liner/shield/pad |
1,400 |
1,236 |
$47K |
| A4253 |
Blood glucose/reagent strips |
1,039 |
1,017 |
$47K |
| A4670 |
Automatic bp monitor, dial |
1,059 |
965 |
$47K |
| A4629 |
Tracheostomy care kit |
1,115 |
959 |
$45K |
| E0565 |
Compressor air power source |
1,214 |
1,142 |
$43K |
| T4522 |
Adult size brief/diaper med |
500 |
439 |
$39K |
| T4525 |
Adult size pull-on sm |
462 |
412 |
$36K |
| B4154 |
Ef spec metabolic noninherit |
395 |
259 |
$34K |
| E0163 |
Commode chair with fixed arm |
1,247 |
1,105 |
$34K |
| K0195 |
Elevating whlchair leg rests |
6,876 |
6,124 |
$34K |
| A4624 |
Tracheal suction tube |
1,034 |
813 |
$34K |
| L3908 |
Who cock-up nonmolde pre ots |
1,026 |
789 |
$34K |
| L1830 |
Ko immob canvas long pre ots |
713 |
705 |
$31K |
| L4361 |
Pneuma/vac walk boot pre ots |
214 |
210 |
$30K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,002 |
902 |
$28K |
| T4523 |
Adult size brief/diaper lg |
357 |
296 |
$27K |
| A7039 |
Filter, non disposable w pap |
4,193 |
3,674 |
$27K |
| E0607 |
Blood glucose monitor home |
602 |
586 |
$25K |
| L4350 |
Ankle control ortho pre ots |
452 |
439 |
$24K |
| A7526 |
Tracheostomy tube collar |
1,216 |
1,035 |
$24K |
| A4927 |
Non-sterile gloves |
2,289 |
1,971 |
$22K |
| E1140 |
Wheelchair standard detach a |
490 |
454 |
$21K |
| E0445 |
Oximeter non-invasive |
79 |
78 |
$21K |
| A4351 |
Straight tip urine catheter |
227 |
203 |
$19K |
| E0244 |
Toilet seat raised |
520 |
463 |
$18K |
| E0971 |
Wheelchair anti-tipping devi |
989 |
515 |
$18K |
| T4530 |
Ped size brief/diaper lg |
273 |
248 |
$18K |
| A7036 |
Pos airway press chinstrap |
2,197 |
1,998 |
$16K |
| A4385 |
Ost skn barrier sld ext wear |
554 |
472 |
$16K |
| B4155 |
Ef incomplete/modular |
354 |
218 |
$15K |
| T4534 |
Youth size pull-on |
179 |
163 |
$15K |
| E2103 |
Non-adju cgm receiver/mon |
284 |
229 |
$14K |
| L3809 |
Whfo w/o joints pre ots |
106 |
98 |
$13K |
| E0156 |
Walker seat attachment |
1,681 |
1,447 |
$12K |
| A7003 |
Nebulizer administration set |
10,039 |
9,180 |
$12K |
| A7000 |
Disposable canister for pump |
1,009 |
837 |
$10K |
| K0554 |
Ther cgm receiver/monitor |
93 |
85 |
$9K |
| E0424 |
Stationary compressed gas 02 |
77 |
73 |
$9K |
| A9278 |
External receiver, cgm sys |
26 |
24 |
$8K |
| A7520 |
Trach/laryn tube non-cuffed |
185 |
167 |
$8K |
| A4259 |
Lancets per box |
928 |
916 |
$7K |
| A4362 |
Solid skin barrier |
213 |
189 |
$7K |
| E0181 |
Press pad alternating w/ pum |
562 |
504 |
$6K |
| E0165 |
Commode chair with detacharm |
360 |
328 |
$6K |
| A4424 |
Ost pch drain w bar & filter |
228 |
173 |
$6K |
| E0776 |
Iv pole |
618 |
546 |
$5K |
| Q0513 |
Disp fee inhal drugs/30 days |
648 |
535 |
$5K |
| B4158 |
Ef ped complete intact nut |
35 |
25 |
$5K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
119 |
103 |
$5K |
| E0185 |
Gel pressure mattress pad |
221 |
193 |
$5K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
111 |
88 |
$4K |
| E0250 |
Hosp bed fixed ht w/ mattres |
491 |
440 |
$4K |
| E2611 |
Gen use back cush wdth <22in |
48 |
41 |
$4K |
| L4387 |
Non-pneum walk boot pre ots |
67 |
59 |
$4K |
| E0961 |
Wheelchair brake extension |
225 |
200 |
$4K |
| A4322 |
Irrigation syringe |
222 |
189 |
$4K |
| A4628 |
Oropharyngeal suction cath |
730 |
600 |
$4K |
| A5120 |
Skin barrier, wipe or swab |
546 |
453 |
$3K |
| E0247 |
Trans bench w/wo comm open |
69 |
59 |
$3K |
| E0277 |
Powered pres-redu air mattrs |
15 |
14 |
$3K |
| E0135 |
Walker folding adjust/fixed |
94 |
81 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
2,748 |
2,487 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
363 |
291 |
$2K |
| A6446 |
Conform band s w>=3" <5"/yd |
84 |
74 |
$2K |
| E1038 |
Transport chair pt wt<=300lb |
222 |
200 |
$2K |
| E0990 |
Wheelchair elevating leg res |
113 |
107 |
$2K |
| A4357 |
Bedside drainage bag |
248 |
209 |
$1K |
| A7002 |
Tubing used w suction pump |
280 |
230 |
$1K |
| E0100 |
Cane adjust/fixed with tip |
135 |
127 |
$1K |
| E1226 |
Manual fully reclining back |
33 |
28 |
$1K |
| L1812 |
Ko elastic w/joints pre ots |
15 |
12 |
$747.42 |
| E0910 |
Trapeze bar attached to bed |
111 |
100 |
$743.46 |
| L1810 |
Ko elastic with joints |
14 |
12 |
$662.49 |
| A7525 |
Tracheostomy mask |
476 |
376 |
$580.42 |
| E0978 |
W/c acc,saf belt pelv strap |
88 |
87 |
$541.23 |
| L3260 |
Ambulatory surgical boot eac |
12 |
12 |
$482.16 |
| A6216 |
Non-sterile gauze<=16 sq in |
75 |
63 |
$409.43 |
| E0184 |
Dry pressure mattress |
91 |
85 |
$394.79 |
| J7620 |
Albuterol ipratrop non-comp |
70 |
51 |
$340.61 |
| A7007 |
Lg vol nebulizer disposable |
110 |
74 |
$302.87 |
| A4371 |
Skin barrier powder per oz |
123 |
109 |
$293.94 |
| A4450 |
Non-waterproof tape |
85 |
71 |
$269.31 |
| E0241 |
Bath tub wall rail |
12 |
12 |
$264.00 |
| E0105 |
Cane adjust/fixed quad/3 pro |
14 |
14 |
$254.63 |
| A7012 |
Nebulizer water collec devic |
150 |
120 |
$226.89 |
| A4452 |
Waterproof tape |
14 |
12 |
$219.83 |
| E0605 |
Vaporizer room type |
12 |
12 |
$210.91 |
| A6450 |
Lt compres band >=5"/yd |
17 |
14 |
$199.58 |
| A4216 |
Sterile water/saline, 10 ml |
33 |
28 |
$178.79 |
| A5063 |
Drain ostomy pouch w/flange |
16 |
12 |
$150.95 |
| A7013 |
Disposable compressor filter |
2,542 |
2,275 |
$147.73 |
| A4402 |
Lubricant per ounce |
68 |
63 |
$144.74 |
| J7613 |
Albuterol non-comp unit |
14 |
13 |
$98.03 |
| E0305 |
Rails bed side half length |
12 |
12 |
$68.63 |
| E1356 |
Batt pack/cart, port conc |
4,209 |
4,196 |
$0.00 |