| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Pwc gp 2 std cap chair |
333 |
333 |
$63K |
| E0601 |
Cont airway pressure device |
2,768 |
2,718 |
$57K |
| K0001 |
Standard wheelchair |
2,653 |
2,614 |
$41K |
| E1161 |
Manual adult wc w tiltinspac |
19 |
18 |
$35K |
| E0295 |
Hosp bed semi-elect w/o matt |
691 |
689 |
$23K |
| K0108 |
W/c component-accessory nos |
121 |
65 |
$23K |
| E1028 |
W/c manual swingaway |
296 |
194 |
$22K |
| E0562 |
Humidifier heated used w pap |
2,347 |
2,299 |
$19K |
| E0973 |
W/ch access det adj armrest |
780 |
487 |
$17K |
| A4604 |
Tubing with heating element |
952 |
941 |
$14K |
| K0003 |
Lightweight wheelchair |
544 |
530 |
$14K |
| E1390 |
Oxygen concentrator |
402 |
396 |
$12K |
| A7034 |
Nasal application device |
370 |
365 |
$9K |
| E0260 |
Hosp bed semi-electr w/ matt |
519 |
518 |
$8K |
| A7035 |
Pos airway press headgear |
761 |
752 |
$7K |
| A7038 |
Pos airway pressure filter |
1,503 |
1,481 |
$6K |
| E0465 |
Home vent invasive interface |
36 |
26 |
$6K |
| A7030 |
Cpap full face mask |
178 |
176 |
$5K |
| E2613 |
Position back cush wd <22in |
16 |
14 |
$5K |
| E0630 |
Patient lift hydraulic |
140 |
140 |
$5K |
| A7033 |
Replacement nasal pillows |
212 |
210 |
$5K |
| E2607 |
Skin pro/pos wc cus wd <22in |
15 |
14 |
$4K |
| K0195 |
Elevating whlchair leg rests |
408 |
404 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
141 |
137 |
$3K |
| E0570 |
Nebulizer with compression |
348 |
335 |
$3K |
| E0955 |
Cushioned headrest |
32 |
29 |
$3K |
| K0739 |
Repair/svc dme non-oxygen eq |
51 |
50 |
$3K |
| E0990 |
Wheelchair elevating leg res |
31 |
15 |
$2K |
| K0040 |
Adjustable angle footplate |
17 |
15 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
72 |
61 |
$2K |
| E2231 |
Solid seat support base |
13 |
12 |
$2K |
| A7031 |
Replacement facemask interfa |
85 |
81 |
$2K |
| A4628 |
Oropharyngeal suction cath |
158 |
150 |
$2K |
| E0431 |
Portable gaseous 02 |
132 |
131 |
$2K |
| A7000 |
Disposable canister for pump |
247 |
234 |
$1K |
| A7002 |
Tubing used w suction pump |
320 |
296 |
$1K |
| E0978 |
W/c acc,saf belt pelv strap |
107 |
101 |
$1K |
| A7046 |
Repl water chamber, pap dev |
184 |
182 |
$1K |
| E2365 |
U1 sealed leadacid battery |
17 |
17 |
$903.23 |
| E0600 |
Suction pump portab hom modl |
28 |
24 |
$882.26 |
| A7526 |
Tracheostomy tube collar |
40 |
39 |
$790.39 |
| E0951 |
Loop heel |
16 |
15 |
$539.39 |
| E0156 |
Walker seat attachment |
52 |
52 |
$251.77 |
| A7032 |
Replacement nasal cushion |
12 |
12 |
$173.30 |
| E0470 |
Rad w/o backup non-inv intfc |
24 |
24 |
$113.97 |