| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
789 |
788 |
$37K |
| E1390 |
Oxygen concentrator |
536 |
533 |
$36K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,290 |
1,288 |
$20K |
| A7030 |
Cpap full face mask |
133 |
132 |
$11K |
| A7037 |
Pos airway pressure tubing |
668 |
663 |
$10K |
| A7035 |
Pos airway press headgear |
707 |
700 |
$8K |
| E0630 |
Patient lift hydraulic |
671 |
669 |
$8K |
| K0002 |
Stnd hemi (low seat) whlchr |
672 |
671 |
$6K |
| K0003 |
Lightweight wheelchair |
261 |
258 |
$5K |
| K0001 |
Standard wheelchair |
771 |
770 |
$5K |
| K0195 |
Elevating whlchair leg rests |
1,474 |
1,453 |
$4K |
| E1031 |
Rollabout chair with casters |
428 |
427 |
$4K |
| E0261 |
Hosp bed semi-electr w/o mat |
488 |
487 |
$4K |
| K0006 |
Heavy duty wheelchair |
195 |
195 |
$3K |
| A7034 |
Nasal application device |
51 |
51 |
$2K |
| K0004 |
High strength ltwt whlchr |
162 |
162 |
$2K |
| A7038 |
Pos airway pressure filter |
748 |
738 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
155 |
148 |
$2K |
| A7031 |
Replacement facemask interfa |
54 |
52 |
$2K |
| E0973 |
W/ch access det adj armrest |
59 |
55 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
59 |
55 |
$599.08 |
| E0163 |
Commode chair with fixed arm |
46 |
44 |
$463.26 |
| E0431 |
Portable gaseous 02 |
25 |
25 |
$460.84 |
| E0255 |
Hospital bed var ht w/ mattr |
26 |
26 |
$364.81 |
| A7032 |
Replacement nasal cushion |
12 |
12 |
$314.86 |
| E2601 |
Gen w/c cushion wdth < 22 in |
35 |
35 |
$260.44 |
| A7039 |
Filter, non disposable w pap |
42 |
42 |
$254.26 |
| E0978 |
W/c acc,saf belt pelv strap |
60 |
56 |
$222.86 |
| E0951 |
Loop heel |
30 |
30 |
$141.52 |
| E2611 |
Gen use back cush wdth <22in |
38 |
38 |
$0.00 |
| E1038 |
Transport chair pt wt<=300lb |
24 |
24 |
$0.00 |