| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,357 |
4,181 |
$427K |
| E0601 |
Cont airway pressure device |
1,048 |
938 |
$133K |
| K0003 |
Lightweight wheelchair |
941 |
853 |
$116K |
| K0001 |
Standard wheelchair |
2,509 |
2,196 |
$110K |
| E0630 |
Patient lift hydraulic |
1,160 |
1,034 |
$89K |
| E1028 |
W/c manual swingaway |
2,854 |
1,838 |
$84K |
| E0143 |
Walker folding wheeled w/o s |
1,495 |
1,406 |
$83K |
| E1161 |
Manual adult wc w tiltinspac |
286 |
284 |
$81K |
| E0431 |
Portable gaseous 02 |
4,018 |
3,821 |
$73K |
| A7030 |
Cpap full face mask |
439 |
432 |
$52K |
| S9999 |
Sales tax |
4,423 |
3,276 |
$39K |
| E0971 |
Wheelchair anti-tipping devi |
1,372 |
742 |
$37K |
| E0973 |
W/ch access det adj armrest |
2,128 |
1,076 |
$37K |
| A4604 |
Tubing with heating element |
681 |
661 |
$28K |
| A7035 |
Pos airway press headgear |
851 |
832 |
$23K |
| E0562 |
Humidifier heated used w pap |
108 |
108 |
$22K |
| A7038 |
Pos airway pressure filter |
2,240 |
2,179 |
$18K |
| E0261 |
Hosp bed semi-electr w/o mat |
948 |
819 |
$18K |
| E0955 |
Cushioned headrest |
592 |
554 |
$17K |
| A4606 |
Oxygen probe used w oximeter |
264 |
254 |
$17K |
| E2601 |
Gen w/c cushion wdth < 22 in |
381 |
362 |
$12K |
| A7034 |
Nasal application device |
150 |
143 |
$10K |
| E0570 |
Nebulizer with compression |
123 |
118 |
$9K |
| E0600 |
Suction pump portab hom modl |
170 |
154 |
$7K |
| E0156 |
Walker seat attachment |
523 |
493 |
$6K |
| E0445 |
Oximeter non-invasive |
13 |
12 |
$6K |
| E0184 |
Dry pressure mattress |
89 |
83 |
$5K |
| K0195 |
Elevating whlchair leg rests |
633 |
569 |
$5K |
| K0108 |
W/c component-accessory nos |
24 |
13 |
$4K |
| E0961 |
Wheelchair brake extension |
145 |
73 |
$2K |
| E0990 |
Wheelchair elevating leg res |
27 |
26 |
$2K |
| E0305 |
Rails bed side half length |
44 |
39 |
$1K |
| E0951 |
Loop heel |
96 |
53 |
$972.19 |
| E0260 |
Hosp bed semi-electr w/ matt |
53 |
50 |
$841.66 |
| A7037 |
Pos airway pressure tubing |
14 |
14 |
$352.11 |
| A4927 |
Non-sterile gloves |
35 |
28 |
$317.41 |
| A7046 |
Repl water chamber, pap dev |
28 |
26 |
$311.18 |
| T4535 |
Disposable liner/shield/pad |
19 |
12 |
$268.71 |
| E0181 |
Press pad alternating w/ pum |
14 |
12 |
$113.34 |
| A7039 |
Filter, non disposable w pap |
12 |
12 |
$111.29 |
| A7003 |
Nebulizer administration set |
13 |
13 |
$31.78 |