| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0001 |
Standard wheelchair |
9,300 |
8,930 |
$335K |
| E0143 |
Walker folding wheeled w/o s |
4,455 |
4,344 |
$230K |
| E1390 |
Oxygen concentrator |
1,258 |
1,247 |
$141K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
2,631 |
2,506 |
$126K |
| E0163 |
Commode chair with fixed arm |
2,118 |
2,057 |
$114K |
| K0821 |
Pwc gp 2 std port cap chair |
497 |
496 |
$111K |
| E0973 |
W/ch access det adj armrest |
9,318 |
5,534 |
$110K |
| E2611 |
Gen use back cush wdth <22in |
819 |
791 |
$110K |
| E0295 |
Hosp bed semi-elect w/o matt |
1,554 |
1,511 |
$106K |
| K0006 |
Heavy duty wheelchair |
1,182 |
1,160 |
$105K |
| K0195 |
Elevating whlchair leg rests |
6,975 |
6,497 |
$96K |
| E0247 |
Trans bench w/wo comm open |
1,135 |
1,131 |
$88K |
| E0245 |
Tub stool or bench |
1,408 |
1,403 |
$75K |
| K0823 |
Pwc gp 2 std cap chair |
111 |
111 |
$68K |
| E1236 |
Folding ped wc adjustable |
321 |
289 |
$58K |
| E0601 |
Cont airway pressure device |
650 |
646 |
$44K |
| L3916 |
Who nontorsion jnts pre ots |
124 |
72 |
$42K |
| E0630 |
Patient lift hydraulic |
754 |
753 |
$38K |
| E0730 |
Tens four lead |
179 |
179 |
$32K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,148 |
1,143 |
$29K |
| L1833 |
Ko adj jnt pos r sup pre ots |
55 |
41 |
$28K |
| K0003 |
Lightweight wheelchair |
822 |
817 |
$27K |
| E0431 |
Portable gaseous 02 |
1,324 |
1,189 |
$27K |
| E2601 |
Gen w/c cushion wdth < 22 in |
830 |
803 |
$25K |
| L0650 |
Lso sc r ant/pos pnl pre ots |
26 |
26 |
$23K |
| E0570 |
Nebulizer with compression |
519 |
518 |
$22K |
| T4527 |
Adult size pull-on lg |
270 |
270 |
$20K |
| E0562 |
Humidifier heated used w pap |
986 |
980 |
$20K |
| E1399 |
Durable medical equipment mi |
532 |
525 |
$19K |
| E0156 |
Walker seat attachment |
1,270 |
1,261 |
$17K |
| E0272 |
Mattress foam rubber |
1,218 |
1,185 |
$14K |
| T4535 |
Disposable liner/shield/pad |
270 |
267 |
$11K |
| E0149 |
Heavy duty wheeled walker |
117 |
115 |
$8K |
| E0105 |
Cane adjust/fixed quad/3 pro |
194 |
194 |
$6K |
| E0305 |
Rails bed side half length |
554 |
554 |
$6K |
| K0007 |
Extra heavy duty wheelchair |
39 |
39 |
$6K |
| T4541 |
Large disposable underpad |
289 |
285 |
$5K |
| E0443 |
Portable 02 contents, gas |
140 |
82 |
$5K |
| E0165 |
Commode chair with detacharm |
396 |
390 |
$5K |
| L0621 |
Sio flex pelvic/sacr pre ots |
66 |
66 |
$5K |
| T4526 |
Adult size pull-on med |
74 |
71 |
$5K |
| E0310 |
Rails bed side full length |
357 |
356 |
$4K |
| A4595 |
Tens suppl 2 lead per month |
188 |
183 |
$4K |
| A7005 |
Nondisposable nebulizer set |
153 |
152 |
$4K |
| E2202 |
Seat width 24-27 in |
74 |
73 |
$3K |
| E2365 |
U1 sealed leadacid battery |
24 |
24 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
377 |
216 |
$2K |
| K0002 |
Stnd hemi (low seat) whlchr |
36 |
36 |
$2K |
| E1226 |
Manual fully reclining back |
25 |
25 |
$1K |
| E0955 |
Cushioned headrest |
25 |
24 |
$1K |
| E0277 |
Powered pres-redu air mattrs |
12 |
12 |
$325.56 |
| A7015 |
Aerosol mask used w nebulize |
142 |
141 |
$225.82 |
| E0966 |
Wheelchair head rest extensi |
27 |
27 |
$223.91 |
| E0978 |
W/c acc,saf belt pelv strap |
33 |
28 |
$86.48 |