| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0265 |
Hosp bed total electr w/ mat |
11,722 |
11,222 |
$777K |
| E1392 |
Portable oxygen concentrator |
3,486 |
3,335 |
$757K |
| E0277 |
Powered pres-redu air mattrs |
3,865 |
3,483 |
$580K |
| E1399 |
Durable medical equipment mi |
3,678 |
2,515 |
$504K |
| E1390 |
Oxygen concentrator |
6,227 |
5,973 |
$492K |
| S5161 |
Emer rspns sys serv permonth |
16,871 |
16,441 |
$434K |
| A9999 |
Dme supply or accessory, nos |
2,525 |
2,338 |
$359K |
| E0601 |
Cont airway pressure device |
4,056 |
3,788 |
$239K |
| E0255 |
Hospital bed var ht w/ mattr |
3,363 |
3,277 |
$224K |
| E0303 |
Hosp bed hvy dty xtra wide |
1,580 |
1,512 |
$212K |
| E0470 |
Rad w/o backup non-inv intfc |
1,082 |
1,030 |
$158K |
| K0001 |
Standard wheelchair |
5,170 |
4,944 |
$132K |
| E0635 |
Patient lift electric |
799 |
774 |
$107K |
| E0144 |
Enclosed walker w rear seat |
1,942 |
1,800 |
$74K |
| E0240 |
Bath/shower chair |
2,389 |
2,215 |
$63K |
| E0570 |
Nebulizer with compression |
5,087 |
4,839 |
$63K |
| E0163 |
Commode chair with fixed arm |
1,654 |
1,521 |
$62K |
| K0738 |
Portable gas oxygen system |
400 |
393 |
$47K |
| E1038 |
Transport chair pt wt<=300lb |
2,197 |
2,096 |
$47K |
| E0562 |
Humidifier heated used w pap |
1,703 |
1,608 |
$39K |
| E0627 |
Seat lift mech, electric any |
831 |
819 |
$37K |
| E0630 |
Patient lift hydraulic |
600 |
589 |
$36K |
| E0621 |
Patient lift sling or seat |
754 |
707 |
$35K |
| E0274 |
Over-bed table |
1,362 |
1,352 |
$31K |
| E0184 |
Dry pressure mattress |
580 |
549 |
$29K |
| E2601 |
Gen w/c cushion wdth < 22 in |
430 |
419 |
$27K |
| E0185 |
Gel pressure mattress pad |
436 |
411 |
$23K |
| E0247 |
Trans bench w/wo comm open |
751 |
729 |
$21K |
| E0430 |
Oxygen system gas portable |
596 |
569 |
$13K |
| E1060 |
Wheelchair detachable arms |
553 |
525 |
$13K |
| K0006 |
Heavy duty wheelchair |
349 |
343 |
$12K |
| S5162 |
Emer rspns system purchase |
281 |
273 |
$11K |
| E0100 |
Cane adjust/fixed with tip |
692 |
674 |
$10K |
| E2603 |
Skin protect wc cus wd <22in |
1,022 |
978 |
$10K |
| E0315 |
Bed accessory brd/tbl/supprt |
106 |
104 |
$10K |
| E0140 |
Walker w trunk support |
627 |
564 |
$9K |
| E0272 |
Mattress foam rubber |
498 |
480 |
$7K |
| E0181 |
Press pad alternating w/ pum |
203 |
202 |
$6K |
| A5500 |
Diab shoe for density insert |
32 |
32 |
$5K |
| E0271 |
Mattress innerspring |
349 |
343 |
$5K |
| A9270 |
Non-covered item or service |
272 |
244 |
$5K |
| E0305 |
Rails bed side half length |
304 |
289 |
$4K |
| E1391 |
Oxygen concentrator, dual |
25 |
25 |
$4K |
| E1354 |
Wheeled cart, port cyl/conc |
341 |
328 |
$4K |
| E1353 |
Oxygen supplies regulator |
296 |
254 |
$4K |
| 98960 |
|
23 |
20 |
$4K |
| E0241 |
Bath tub wall rail |
15 |
13 |
$4K |
| E0471 |
Rad w/backup non inv intrfc |
13 |
13 |
$4K |
| A5512 |
Multi den insert direct form |
16 |
16 |
$3K |
| E0260 |
Hosp bed semi-electr w/ matt |
40 |
37 |
$3K |
| A9280 |
Alert device, noc |
134 |
124 |
$3K |
| E0940 |
Trapeze bar free standing |
160 |
159 |
$2K |
| A9900 |
Supply/accessory/service |
35 |
31 |
$2K |
| E2604 |
Skin protect wc cus wd>=22in |
178 |
172 |
$2K |
| E1226 |
Manual fully reclining back |
26 |
25 |
$1K |
| A7030 |
Cpap full face mask |
14 |
14 |
$1K |
| E0443 |
Portable 02 contents, gas |
27 |
20 |
$949.50 |
| E0434 |
Portable liquid 02 |
27 |
27 |
$750.00 |
| K0045 |
Ftrst compl assembly repl ea |
57 |
57 |
$719.30 |
| E0431 |
Portable gaseous 02 |
31 |
24 |
$627.50 |
| A4615 |
Cannula nasal |
90 |
59 |
$622.50 |
| E0141 |
Rigid wheeled walker adj/fix |
40 |
40 |
$600.00 |
| A4467 |
Belt strap sleev grmnt cover |
15 |
12 |
$419.77 |
| A7038 |
Pos airway pressure filter |
33 |
28 |
$265.02 |
| E0990 |
Wheelchair elevating leg res |
15 |
14 |
$187.10 |
| A4616 |
Tubing (oxygen) per foot |
17 |
16 |
$78.00 |