| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
6,185 |
2,284 |
$591K |
| E1399 |
Durable medical equipment mi |
880 |
250 |
$510K |
| K0823 |
Pwc gp 2 std cap chair |
4,465 |
3,607 |
$403K |
| E1161 |
Manual adult wc w tiltinspac |
2,840 |
2,034 |
$367K |
| E0260 |
Hosp bed semi-electr w/ matt |
7,424 |
6,393 |
$302K |
| K0825 |
Pwc gp 2 hd cap chair |
1,165 |
935 |
$189K |
| E1028 |
W/c manual swingaway |
7,990 |
3,701 |
$169K |
| K0001 |
Standard wheelchair |
10,433 |
8,479 |
$156K |
| E0630 |
Patient lift hydraulic |
3,146 |
2,721 |
$93K |
| E0118 |
Crutch substitute |
2,103 |
1,660 |
$91K |
| K0739 |
Repair/svc dme non-oxygen eq |
6,079 |
4,727 |
$89K |
| E0277 |
Powered pres-redu air mattrs |
497 |
422 |
$83K |
| K0821 |
Pwc gp 2 std port cap chair |
632 |
533 |
$80K |
| E0973 |
W/ch access det adj armrest |
1,891 |
1,327 |
$68K |
| E0955 |
Cushioned headrest |
3,629 |
2,649 |
$62K |
| K0195 |
Elevating whlchair leg rests |
9,734 |
7,739 |
$60K |
| E0601 |
Cont airway pressure device |
831 |
732 |
$60K |
| E0240 |
Bath/shower chair |
549 |
470 |
$53K |
| E1007 |
Pwr seat combo w/shear |
12 |
12 |
$50K |
| K0006 |
Heavy duty wheelchair |
1,324 |
1,059 |
$46K |
| K0003 |
Lightweight wheelchair |
1,344 |
1,082 |
$38K |
| E0570 |
Nebulizer with compression |
1,497 |
1,306 |
$35K |
| K0861 |
Pwc gp3 std mult pow opt s/b |
12 |
12 |
$33K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,248 |
1,115 |
$33K |
| A4604 |
Tubing with heating element |
863 |
821 |
$26K |
| A7030 |
Cpap full face mask |
356 |
341 |
$24K |
| E2365 |
U1 sealed leadacid battery |
475 |
379 |
$23K |
| E0971 |
Wheelchair anti-tipping devi |
1,124 |
747 |
$21K |
| E0143 |
Walker folding wheeled w/o s |
910 |
784 |
$20K |
| E1012 |
Ctr mount pwr elev leg rest |
50 |
41 |
$17K |
| E2311 |
Electro connect btw 2 sys |
13 |
12 |
$14K |
| A7035 |
Pos airway press headgear |
907 |
862 |
$13K |
| E0163 |
Commode chair with fixed arm |
445 |
414 |
$12K |
| E0562 |
Humidifier heated used w pap |
639 |
556 |
$12K |
| K0005 |
Ultralightweight wheelchair |
13 |
12 |
$11K |
| E0301 |
Hd hosp bed, 350-600 lbs |
223 |
197 |
$11K |
| K0040 |
Adjustable angle footplate |
284 |
191 |
$10K |
| E0247 |
Trans bench w/wo comm open |
89 |
77 |
$9K |
| E2620 |
Wc planar back cush wd <22in |
30 |
24 |
$7K |
| E0978 |
W/c acc,saf belt pelv strap |
571 |
470 |
$6K |
| E0250 |
Hosp bed fixed ht w/ mattres |
393 |
286 |
$6K |
| E2622 |
Adj skin pro w/c cus wd<22in |
50 |
41 |
$5K |
| E2313 |
Pwc harness, expand control |
28 |
24 |
$5K |
| A7031 |
Replacement facemask interfa |
147 |
138 |
$5K |
| E0600 |
Suction pump portab hom modl |
243 |
206 |
$4K |
| E2377 |
Expandable controller, initl |
14 |
12 |
$4K |
| E0910 |
Trapeze bar attached to bed |
667 |
567 |
$4K |
| E0156 |
Walker seat attachment |
447 |
379 |
$3K |
| A7038 |
Pos airway pressure filter |
1,451 |
1,208 |
$3K |
| E1038 |
Transport chair pt wt<=300lb |
645 |
484 |
$3K |
| E2361 |
22nf sealed leadacid battery |
29 |
26 |
$3K |
| E0181 |
Press pad alternating w/ pum |
362 |
317 |
$3K |
| E2203 |
Frame depth less than 22 in |
14 |
12 |
$2K |
| E0303 |
Hosp bed hvy dty xtra wide |
50 |
36 |
$2K |
| E2392 |
Solid caster tire, integrate |
55 |
38 |
$2K |
| E2219 |
Foam caster tire any size ea |
50 |
41 |
$2K |
| E2611 |
Gen use back cush wdth <22in |
55 |
40 |
$2K |
| E0165 |
Commode chair with detacharm |
84 |
77 |
$2K |
| E0956 |
W/c lateral trunk/hip suppor |
18 |
12 |
$2K |
| E2394 |
Drive wheel excludes tire |
40 |
26 |
$2K |
| E0961 |
Wheelchair brake extension |
124 |
95 |
$2K |
| E2213 |
Pneumatic prop tire insert |
82 |
54 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
110 |
84 |
$1K |
| E2386 |
Foam filled drive wheel tire |
16 |
12 |
$1K |
| E2211 |
Pneumatic propulsion tire |
58 |
41 |
$1K |
| K0019 |
Arm pad repl, each |
187 |
125 |
$1K |
| A7046 |
Repl water chamber, pap dev |
103 |
98 |
$1K |
| E2395 |
Caster wheel excludes tire |
13 |
13 |
$922.15 |
| A7034 |
Nasal application device |
14 |
14 |
$482.56 |
| E0149 |
Heavy duty wheeled walker |
21 |
14 |
$402.12 |
| A7003 |
Nebulizer administration set |
208 |
194 |
$370.76 |
| E0730 |
Tens four lead |
20 |
14 |
$328.83 |
| A4628 |
Oropharyngeal suction cath |
38 |
25 |
$236.03 |
| A7002 |
Tubing used w suction pump |
40 |
26 |
$208.77 |
| A7015 |
Aerosol mask used w nebulize |
137 |
129 |
$174.32 |
| E2210 |
Wheelchair bearings |
15 |
14 |
$127.69 |
| E0951 |
Loop heel |
16 |
12 |
$95.74 |
| A7000 |
Disposable canister for pump |
40 |
26 |
$86.13 |