| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
805 |
429 |
$543K |
| E1390 |
Oxygen concentrator |
6,297 |
5,300 |
$204K |
| K0005 |
Ultralightweight wheelchair |
128 |
110 |
$198K |
| E0601 |
Cont airway pressure device |
9,923 |
8,365 |
$187K |
| A7030 |
Cpap full face mask |
3,054 |
2,468 |
$88K |
| A7034 |
Nasal application device |
3,587 |
2,889 |
$71K |
| K0823 |
Pwc gp 2 std cap chair |
1,296 |
1,164 |
$64K |
| E0562 |
Humidifier heated used w pap |
2,083 |
1,590 |
$61K |
| E2607 |
Skin pro/pos wc cus wd <22in |
413 |
276 |
$55K |
| A7038 |
Pos airway pressure filter |
7,549 |
5,835 |
$55K |
| A7031 |
Replacement facemask interfa |
2,844 |
2,214 |
$54K |
| E0973 |
W/ch access det adj armrest |
890 |
520 |
$51K |
| A7032 |
Replacement nasal cushion |
1,956 |
1,530 |
$51K |
| E1161 |
Manual adult wc w tiltinspac |
35 |
25 |
$45K |
| E0470 |
Rad w/o backup non-inv intfc |
1,085 |
886 |
$43K |
| E1028 |
W/c manual swingaway |
3,503 |
2,543 |
$41K |
| E0570 |
Nebulizer with compression |
4,751 |
4,037 |
$35K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,492 |
1,265 |
$34K |
| A7035 |
Pos airway press headgear |
4,367 |
3,535 |
$30K |
| A4604 |
Tubing with heating element |
4,906 |
3,994 |
$24K |
| E1392 |
Portable oxygen concentrator |
3,273 |
2,745 |
$21K |
| K0001 |
Standard wheelchair |
2,816 |
2,430 |
$21K |
| E0971 |
Wheelchair anti-tipping devi |
408 |
294 |
$19K |
| A7037 |
Pos airway pressure tubing |
1,749 |
1,363 |
$18K |
| A7033 |
Replacement nasal pillows |
856 |
652 |
$17K |
| E0143 |
Walker folding wheeled w/o s |
701 |
584 |
$14K |
| E2203 |
Frame depth less than 22 in |
32 |
28 |
$12K |
| K0821 |
Pwc gp 2 std port cap chair |
118 |
103 |
$12K |
| A7046 |
Repl water chamber, pap dev |
2,663 |
2,126 |
$11K |
| E0431 |
Portable gaseous 02 |
978 |
858 |
$9K |
| E2613 |
Position back cush wd <22in |
39 |
28 |
$9K |
| K0003 |
Lightweight wheelchair |
661 |
592 |
$8K |
| E0961 |
Wheelchair brake extension |
241 |
186 |
$8K |
| E0951 |
Loop heel |
284 |
210 |
$5K |
| E0149 |
Heavy duty wheeled walker |
516 |
451 |
$4K |
| E2211 |
Pneumatic propulsion tire |
153 |
57 |
$3K |
| E0955 |
Cushioned headrest |
59 |
28 |
$3K |
| E0630 |
Patient lift hydraulic |
255 |
191 |
$3K |
| E0156 |
Walker seat attachment |
229 |
178 |
$738.76 |
| E2213 |
Pneumatic prop tire insert |
22 |
14 |
$707.25 |
| E0165 |
Commode chair with detacharm |
41 |
37 |
$545.89 |
| A7039 |
Filter, non disposable w pap |
151 |
109 |
$488.86 |
| A7003 |
Nebulizer administration set |
447 |
351 |
$478.18 |
| A7015 |
Aerosol mask used w nebulize |
301 |
255 |
$221.74 |
| A7036 |
Pos airway press chinstrap |
15 |
12 |
$53.23 |