| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,760 |
3,705 |
$88K |
| E0260 |
Hosp bed semi-electr w/ matt |
6,567 |
6,496 |
$81K |
| K0001 |
Standard wheelchair |
9,731 |
9,658 |
$43K |
| K0816 |
Pwc gp 1 std cap chair |
575 |
573 |
$21K |
| E0630 |
Patient lift hydraulic |
1,808 |
1,784 |
$20K |
| E0431 |
Portable gaseous 02 |
3,200 |
3,133 |
$15K |
| K0003 |
Lightweight wheelchair |
1,767 |
1,748 |
$12K |
| E0143 |
Walker folding wheeled w/o s |
1,123 |
1,022 |
$11K |
| E0163 |
Commode chair with fixed arm |
1,013 |
875 |
$11K |
| E0185 |
Gel pressure mattress pad |
312 |
286 |
$11K |
| E0277 |
Powered pres-redu air mattrs |
182 |
182 |
$6K |
| E0601 |
Cont airway pressure device |
391 |
387 |
$6K |
| K0195 |
Elevating whlchair leg rests |
3,187 |
3,164 |
$6K |
| E0971 |
Wheelchair anti-tipping devi |
840 |
511 |
$5K |
| E0250 |
Hosp bed fixed ht w/ mattres |
386 |
385 |
$4K |
| E2601 |
Gen w/c cushion wdth < 22 in |
652 |
582 |
$4K |
| A7030 |
Cpap full face mask |
55 |
53 |
$2K |
| K0800 |
Pov group 1 std up to 300lbs |
79 |
79 |
$2K |
| K0006 |
Heavy duty wheelchair |
182 |
181 |
$2K |
| A7031 |
Replacement facemask interfa |
113 |
107 |
$2K |
| E0114 |
Crutch underarm pair no wood |
82 |
75 |
$1K |
| E2611 |
Gen use back cush wdth <22in |
598 |
532 |
$1K |
| E0973 |
W/ch access det adj armrest |
89 |
42 |
$787.00 |
| E0951 |
Loop heel |
415 |
189 |
$761.49 |
| E0910 |
Trapeze bar attached to bed |
307 |
305 |
$683.69 |
| A7038 |
Pos airway pressure filter |
275 |
245 |
$648.37 |
| E0961 |
Wheelchair brake extension |
78 |
72 |
$490.14 |
| L3660 |
So 8 ab rstr can/web pre ots |
13 |
13 |
$449.40 |
| E0181 |
Press pad alternating w/ pum |
122 |
121 |
$416.43 |
| L3670 |
So acro/clav can web pre ots |
13 |
13 |
$382.45 |
| E0570 |
Nebulizer with compression |
225 |
219 |
$206.50 |
| A7037 |
Pos airway pressure tubing |
14 |
13 |
$137.50 |
| E0165 |
Commode chair with detacharm |
95 |
93 |
$96.46 |
| E0149 |
Heavy duty wheeled walker |
24 |
24 |
$71.17 |
| A6402 |
Sterile gauze <= 16 sq in |
87 |
76 |
$28.60 |
| A7046 |
Repl water chamber, pap dev |
13 |
12 |
$9.89 |
| E1035 |
Patient transfer system <300 |
162 |
162 |
$0.27 |
| E1392 |
Portable oxygen concentrator |
129 |
128 |
$0.00 |
| A4604 |
Tubing with heating element |
27 |
26 |
$0.00 |