| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
2,264 |
1,379 |
$388K |
| E1390 |
Oxygen concentrator |
8,234 |
7,733 |
$233K |
| E0260 |
Hosp bed semi-electr w/ matt |
7,210 |
6,727 |
$149K |
| K0003 |
Lightweight wheelchair |
4,458 |
4,202 |
$74K |
| B4154 |
Ef spec metabolic noninherit |
735 |
714 |
$57K |
| A4624 |
Tracheal suction tube |
1,464 |
1,294 |
$43K |
| K0001 |
Standard wheelchair |
3,796 |
3,362 |
$39K |
| A4623 |
Tracheostomy inner cannula |
1,441 |
1,304 |
$39K |
| B4035 |
Enteral feed supp pump per d |
1,268 |
1,204 |
$37K |
| A4629 |
Tracheostomy care kit |
1,489 |
1,311 |
$36K |
| E0630 |
Patient lift hydraulic |
1,944 |
1,829 |
$33K |
| B4152 |
Ef calorie dense>/=1.5kcal |
946 |
891 |
$32K |
| E0431 |
Portable gaseous 02 |
7,734 |
7,223 |
$28K |
| B4034 |
Enter feed supkit syr by day |
1,412 |
1,334 |
$28K |
| E0143 |
Walker folding wheeled w/o s |
1,032 |
914 |
$26K |
| E0601 |
Cont airway pressure device |
1,067 |
1,025 |
$22K |
| K0006 |
Heavy duty wheelchair |
850 |
803 |
$16K |
| K0195 |
Elevating whlchair leg rests |
2,751 |
2,515 |
$16K |
| K0007 |
Extra heavy duty wheelchair |
648 |
594 |
$16K |
| E0443 |
Portable 02 contents, gas |
2,462 |
2,150 |
$15K |
| E0163 |
Commode chair with fixed arm |
1,202 |
1,056 |
$15K |
| E0303 |
Hosp bed hvy dty xtra wide |
122 |
113 |
$13K |
| E2601 |
Gen w/c cushion wdth < 22 in |
770 |
679 |
$13K |
| E0600 |
Suction pump portab hom modl |
1,262 |
1,166 |
$11K |
| E0570 |
Nebulizer with compression |
4,038 |
3,929 |
$10K |
| B4150 |
Ef complet w/intact nutrient |
184 |
173 |
$9K |
| E0165 |
Commode chair with detacharm |
1,371 |
1,302 |
$7K |
| E0185 |
Gel pressure mattress pad |
218 |
183 |
$7K |
| A7526 |
Tracheostomy tube collar |
548 |
483 |
$5K |
| E0971 |
Wheelchair anti-tipping devi |
782 |
680 |
$5K |
| E0973 |
W/ch access det adj armrest |
278 |
133 |
$4K |
| A4628 |
Oropharyngeal suction cath |
1,314 |
1,216 |
$4K |
| A7000 |
Disposable canister for pump |
1,148 |
1,043 |
$3K |
| B9002 |
Enter nutr inf pump any type |
229 |
212 |
$3K |
| E0951 |
Loop heel |
1,033 |
796 |
$2K |
| E0470 |
Rad w/o backup non-inv intfc |
50 |
48 |
$2K |
| A7002 |
Tubing used w suction pump |
1,859 |
1,308 |
$2K |
| E0562 |
Humidifier heated used w pap |
118 |
107 |
$2K |
| A7030 |
Cpap full face mask |
41 |
39 |
$2K |
| A7038 |
Pos airway pressure filter |
461 |
447 |
$1K |
| A7037 |
Pos airway pressure tubing |
121 |
116 |
$946.62 |
| E0978 |
W/c acc,saf belt pelv strap |
664 |
591 |
$940.36 |
| E0149 |
Heavy duty wheeled walker |
194 |
175 |
$651.92 |
| E0181 |
Press pad alternating w/ pum |
68 |
63 |
$340.03 |
| A7003 |
Nebulizer administration set |
277 |
255 |
$303.74 |
| E0565 |
Compressor air power source |
14 |
12 |
$177.12 |
| A7035 |
Pos airway press headgear |
12 |
12 |
$99.84 |
| E0776 |
Iv pole |
18 |
16 |
$75.11 |