| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
11,539 |
10,366 |
$817K |
| A7030 |
Cpap full face mask |
8,107 |
7,382 |
$645K |
| K0823 |
Pwc gp 2 std cap chair |
6,455 |
5,827 |
$538K |
| E1390 |
Oxygen concentrator |
14,064 |
11,840 |
$532K |
| A7031 |
Replacement facemask interfa |
14,538 |
12,881 |
$517K |
| E0570 |
Nebulizer with compression |
15,693 |
14,060 |
$333K |
| E0260 |
Hosp bed semi-electr w/ matt |
8,894 |
7,809 |
$289K |
| E0562 |
Humidifier heated used w pap |
3,956 |
3,586 |
$219K |
| A7037 |
Pos airway pressure tubing |
10,661 |
9,756 |
$209K |
| E0470 |
Rad w/o backup non-inv intfc |
1,333 |
1,175 |
$195K |
| K0003 |
Lightweight wheelchair |
7,855 |
6,687 |
$185K |
| A7032 |
Replacement nasal cushion |
3,676 |
3,284 |
$171K |
| E0143 |
Walker folding wheeled w/o s |
4,334 |
3,807 |
$152K |
| A7038 |
Pos airway pressure filter |
22,205 |
20,214 |
$145K |
| A7034 |
Nasal application device |
2,515 |
2,299 |
$144K |
| A7035 |
Pos airway press headgear |
6,744 |
6,142 |
$121K |
| K0001 |
Standard wheelchair |
11,587 |
10,170 |
$119K |
| E0630 |
Patient lift hydraulic |
3,149 |
2,693 |
$81K |
| K0006 |
Heavy duty wheelchair |
2,450 |
2,122 |
$68K |
| A7033 |
Replacement nasal pillows |
1,805 |
1,619 |
$58K |
| E0163 |
Commode chair with fixed arm |
2,524 |
2,200 |
$48K |
| E0431 |
Portable gaseous 02 |
11,563 |
9,620 |
$43K |
| K0007 |
Extra heavy duty wheelchair |
1,678 |
1,456 |
$41K |
| K0825 |
Pwc gp 2 hd cap chair |
216 |
161 |
$36K |
| E0240 |
Bath/shower chair |
851 |
556 |
$33K |
| K0195 |
Elevating whlchair leg rests |
2,851 |
2,469 |
$33K |
| L4387 |
Non-pneum walk boot pre ots |
330 |
285 |
$31K |
| T4528 |
Adult size pull-on xl |
45 |
45 |
$27K |
| T4541 |
Large disposable underpad |
176 |
173 |
$26K |
| E2365 |
U1 sealed leadacid battery |
481 |
403 |
$26K |
| A7039 |
Filter, non disposable w pap |
3,862 |
3,536 |
$23K |
| A5500 |
Diab shoe for density insert |
920 |
435 |
$22K |
| T4523 |
Adult size brief/diaper lg |
45 |
43 |
$20K |
| E0156 |
Walker seat attachment |
3,064 |
2,714 |
$20K |
| L1812 |
Ko elastic w/joints pre ots |
344 |
259 |
$19K |
| E2202 |
Seat width 24-27 in |
769 |
674 |
$17K |
| E0295 |
Hosp bed semi-elect w/o matt |
1,336 |
1,195 |
$17K |
| E2611 |
Gen use back cush wdth <22in |
269 |
222 |
$15K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
731 |
594 |
$15K |
| E0971 |
Wheelchair anti-tipping devi |
2,042 |
763 |
$12K |
| T4526 |
Adult size pull-on med |
28 |
24 |
$11K |
| E0168 |
Heavyduty/wide commode chair |
1,008 |
917 |
$10K |
| L3908 |
Who cock-up nonmolde pre ots |
398 |
257 |
$10K |
| A5512 |
Multi den insert direct form |
941 |
446 |
$10K |
| A7003 |
Nebulizer administration set |
6,645 |
6,186 |
$10K |
| E0443 |
Portable 02 contents, gas |
988 |
759 |
$9K |
| E0149 |
Heavy duty wheeled walker |
2,387 |
2,119 |
$8K |
| T4540 |
Reusable underpad chair size |
44 |
44 |
$7K |
| E2601 |
Gen w/c cushion wdth < 22 in |
381 |
324 |
$7K |
| T4527 |
Adult size pull-on lg |
13 |
13 |
$6K |
| T4522 |
Adult size brief/diaper med |
15 |
15 |
$6K |
| E0277 |
Powered pres-redu air mattrs |
115 |
95 |
$4K |
| E1392 |
Portable oxygen concentrator |
398 |
348 |
$3K |
| E0951 |
Loop heel |
754 |
293 |
$3K |
| L4386 |
Non-pneum walk boot pre cst |
30 |
26 |
$3K |
| K0800 |
Pov group 1 std up to 300lbs |
16 |
16 |
$2K |
| E0185 |
Gel pressure mattress pad |
64 |
57 |
$2K |
| E0271 |
Mattress innerspring |
164 |
153 |
$2K |
| E0310 |
Rails bed side full length |
1,079 |
1,011 |
$2K |
| E0910 |
Trapeze bar attached to bed |
321 |
272 |
$1K |
| E0165 |
Commode chair with detacharm |
257 |
236 |
$1K |
| A7036 |
Pos airway press chinstrap |
126 |
107 |
$952.66 |
| E0114 |
Crutch underarm pair no wood |
29 |
24 |
$659.57 |
| B9002 |
Enter nutr inf pump any type |
53 |
38 |
$570.89 |
| K0739 |
Repair/svc dme non-oxygen eq |
16 |
12 |
$159.20 |
| A7046 |
Repl water chamber, pap dev |
17 |
15 |
$122.66 |