| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads |
2,791 |
2,665 |
$94K |
| T4527 |
Adult size pull-on lg |
646 |
631 |
$78K |
| E0601 |
Cont airway pressure device |
1,531 |
1,494 |
$52K |
| T4526 |
Adult size pull-on med |
453 |
428 |
$41K |
| T4535 |
Disposable liner/shield/pad |
1,146 |
1,094 |
$37K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,892 |
1,852 |
$31K |
| A4335 |
Incontinence supply |
3,445 |
3,299 |
$17K |
| E1035 |
Patient transfer system <300 |
1,709 |
1,435 |
$16K |
| E0562 |
Humidifier heated used w pap |
881 |
863 |
$15K |
| K0001 |
Standard wheelchair |
1,930 |
1,913 |
$9K |
| K0003 |
Lightweight wheelchair |
893 |
884 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
416 |
413 |
$6K |
| E1390 |
Oxygen concentrator |
143 |
133 |
$5K |
| A7031 |
Replacement facemask interfa |
100 |
96 |
$3K |
| A7030 |
Cpap full face mask |
51 |
50 |
$3K |
| A7037 |
Pos airway pressure tubing |
151 |
145 |
$2K |
| A7038 |
Pos airway pressure filter |
362 |
344 |
$1K |
| E0185 |
Gel pressure mattress pad |
30 |
29 |
$1K |
| E0431 |
Portable gaseous 02 |
114 |
109 |
$743.87 |
| E2601 |
Gen w/c cushion wdth < 22 in |
90 |
88 |
$676.37 |
| E2611 |
Gen use back cush wdth <22in |
124 |
122 |
$670.78 |
| E0156 |
Walker seat attachment |
396 |
395 |
$576.92 |
| A7035 |
Pos airway press headgear |
56 |
56 |
$428.40 |
| E0470 |
Rad w/o backup non-inv intfc |
28 |
25 |
$426.64 |
| E2602 |
Gen w/c cushion wdth >=22 in |
31 |
31 |
$268.59 |
| K0195 |
Elevating whlchair leg rests |
208 |
150 |
$252.44 |
| K0002 |
Stnd hemi (low seat) whlchr |
25 |
25 |
$199.37 |
| A7039 |
Filter, non disposable w pap |
14 |
14 |
$15.66 |