| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
2,403 |
1,878 |
$1.77M |
| E1390 |
Oxygen concentrator |
5,982 |
4,305 |
$331K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,940 |
2,225 |
$210K |
| E1150 |
Wheelchair standard w/ leg r |
4,581 |
2,543 |
$172K |
| E0430 |
Oxygen system gas portable |
1,348 |
969 |
$99K |
| E0143 |
Walker folding wheeled w/o s |
1,968 |
1,227 |
$83K |
| E0431 |
Portable gaseous 02 |
3,449 |
2,484 |
$72K |
| K0001 |
Standard wheelchair |
3,771 |
3,198 |
$53K |
| E0630 |
Patient lift hydraulic |
1,793 |
1,186 |
$47K |
| E0163 |
Commode chair with fixed arm |
1,043 |
677 |
$35K |
| E1240 |
Whchr litwt det arm leg rest |
128 |
69 |
$29K |
| K0003 |
Lightweight wheelchair |
1,221 |
988 |
$28K |
| E0600 |
Suction pump portab hom modl |
576 |
371 |
$13K |
| K0195 |
Elevating whlchair leg rests |
2,624 |
2,082 |
$10K |
| E2601 |
Gen w/c cushion wdth < 22 in |
83 |
54 |
$9K |
| E0240 |
Bath/shower chair |
53 |
24 |
$8K |
| E0971 |
Wheelchair anti-tipping devi |
2,119 |
907 |
$7K |
| A4554 |
Disposable underpads |
67 |
50 |
$7K |
| E0247 |
Trans bench w/wo comm open |
133 |
59 |
$7K |
| E0973 |
W/ch access det adj armrest |
2,555 |
1,057 |
$6K |
| E0114 |
Crutch underarm pair no wood |
89 |
40 |
$1K |
| E0181 |
Press pad alternating w/ pum |
178 |
105 |
$785.23 |
| E0165 |
Commode chair with detacharm |
186 |
138 |
$442.65 |
| E0149 |
Heavy duty wheeled walker |
18 |
12 |
$401.42 |
| E0570 |
Nebulizer with compression |
40 |
25 |
$333.61 |
| A4927 |
Non-sterile gloves |
20 |
12 |
$130.44 |