| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
23,763 |
23,712 |
$417K |
| E1390 |
Oxygen concentrator |
15,062 |
14,924 |
$377K |
| E0562 |
Humidifier heated used w pap |
23,426 |
23,342 |
$182K |
| E0470 |
Rad w/o backup non-inv intfc |
3,310 |
3,304 |
$165K |
| K0001 |
Standard wheelchair |
10,949 |
10,883 |
$114K |
| E0443 |
Portable 02 contents, gas |
9,321 |
9,257 |
$84K |
| A7034 |
Nasal application device |
3,227 |
3,220 |
$79K |
| A4604 |
Tubing with heating element |
4,619 |
4,607 |
$69K |
| E0295 |
Hosp bed semi-elect w/o matt |
2,761 |
2,738 |
$59K |
| E0431 |
Portable gaseous 02 |
13,167 |
13,039 |
$59K |
| A7030 |
Cpap full face mask |
1,621 |
1,616 |
$52K |
| A7035 |
Pos airway press headgear |
4,763 |
4,755 |
$39K |
| E0570 |
Nebulizer with compression |
1,802 |
1,794 |
$32K |
| E0143 |
Walker folding wheeled w/o s |
2,285 |
2,268 |
$31K |
| A7032 |
Replacement nasal cushion |
2,501 |
2,489 |
$28K |
| A7033 |
Replacement nasal pillows |
1,491 |
1,477 |
$27K |
| E0245 |
Tub stool or bench |
1,187 |
1,181 |
$21K |
| K0003 |
Lightweight wheelchair |
1,504 |
1,483 |
$21K |
| A7046 |
Repl water chamber, pap dev |
3,994 |
3,984 |
$20K |
| A7031 |
Replacement facemask interfa |
1,414 |
1,406 |
$19K |
| E0163 |
Commode chair with fixed arm |
859 |
856 |
$14K |
| A7038 |
Pos airway pressure filter |
6,214 |
6,176 |
$14K |
| K0195 |
Elevating whlchair leg rests |
3,055 |
3,029 |
$13K |
| E0630 |
Patient lift hydraulic |
992 |
989 |
$12K |
| E0247 |
Trans bench w/wo comm open |
395 |
394 |
$11K |
| E0305 |
Rails bed side half length |
2,535 |
2,519 |
$8K |
| E0272 |
Mattress foam rubber |
1,967 |
1,956 |
$8K |
| E1392 |
Portable oxygen concentrator |
574 |
573 |
$7K |
| E0600 |
Suction pump portab hom modl |
366 |
366 |
$6K |
| E0971 |
Wheelchair anti-tipping devi |
2,295 |
2,069 |
$5K |
| A7039 |
Filter, non disposable w pap |
2,440 |
2,432 |
$3K |
| E1038 |
Transport chair pt wt<=300lb |
607 |
607 |
$3K |
| T4526 |
Adult size pull-on med |
179 |
169 |
$3K |
| E2611 |
Gen use back cush wdth <22in |
54 |
54 |
$2K |
| A7036 |
Pos airway press chinstrap |
598 |
594 |
$2K |
| A7005 |
Nondisposable nebulizer set |
693 |
687 |
$2K |
| T4541 |
Large disposable underpad |
319 |
313 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
137 |
137 |
$1K |
| T4535 |
Disposable liner/shield/pad |
85 |
77 |
$1K |
| A7037 |
Pos airway pressure tubing |
248 |
247 |
$1K |
| E0978 |
W/c acc,saf belt pelv strap |
1,431 |
1,415 |
$1K |
| E0961 |
Wheelchair brake extension |
594 |
431 |
$1K |
| E0156 |
Walker seat attachment |
438 |
438 |
$978.56 |
| A4670 |
Automatic bp monitor, dial |
51 |
51 |
$792.88 |
| T4527 |
Adult size pull-on lg |
95 |
94 |
$621.91 |
| T4528 |
Adult size pull-on xl |
27 |
26 |
$613.70 |
| E1399 |
Durable medical equipment mi |
142 |
138 |
$462.33 |
| E1226 |
Manual fully reclining back |
24 |
24 |
$447.01 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
25 |
25 |
$381.87 |
| E0271 |
Mattress innerspring |
219 |
218 |
$342.14 |
| E0441 |
Stationary o2 contents, gas |
405 |
392 |
$232.38 |
| E0260 |
Hosp bed semi-electr w/ matt |
40 |
40 |
$188.46 |
| K0002 |
Stnd hemi (low seat) whlchr |
12 |
12 |
$119.32 |
| E0240 |
Bath/shower chair |
12 |
12 |
$93.25 |
| K0052 |
Swingaway detach ftrest repl |
13 |
13 |
$19.08 |
| A7015 |
Aerosol mask used w nebulize |
24 |
24 |
$11.28 |
| A6446 |
Conform band s w>=3" <5"/yd |
254 |
242 |
$0.00 |
| A6402 |
Sterile gauze <= 16 sq in |
239 |
196 |
$0.00 |
| A6403 |
Sterile gauze>16 <= 48 sq in |
282 |
269 |
$0.00 |
| A6253 |
Absorpt drg > 48 sq in w/o b |
30 |
30 |
$0.00 |
| A6197 |
Alginate drsg >16 <=48 sq in |
24 |
24 |
$0.00 |