| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0821 |
Pwc gp 2 std port cap chair |
7,419 |
6,797 |
$368K |
| K0003 |
Lightweight wheelchair |
13,363 |
12,714 |
$352K |
| E1007 |
Pwr seat combo w/shear |
205 |
165 |
$337K |
| E0277 |
Powered pres-redu air mattrs |
2,132 |
2,020 |
$317K |
| E0260 |
Hosp bed semi-electr w/ matt |
5,898 |
5,573 |
$227K |
| K0825 |
Pwc gp 2 hd cap chair |
2,073 |
1,841 |
$179K |
| K0823 |
Pwc gp 2 std cap chair |
1,299 |
1,192 |
$166K |
| E0466 |
Home vent non-invasive inter |
606 |
463 |
$138K |
| A4554 |
Disposable underpads |
3,868 |
3,831 |
$138K |
| E0973 |
W/ch access det adj armrest |
5,968 |
3,394 |
$132K |
| E1002 |
Pwr seat tilt |
290 |
238 |
$120K |
| E1390 |
Oxygen concentrator |
2,341 |
2,326 |
$97K |
| T4527 |
Adult size pull-on lg |
645 |
637 |
$87K |
| E0250 |
Hosp bed fixed ht w/ mattres |
6,620 |
6,503 |
$86K |
| T4526 |
Adult size pull-on med |
695 |
690 |
$83K |
| K0001 |
Standard wheelchair |
12,761 |
12,468 |
$82K |
| E2311 |
Electro connect btw 2 sys |
167 |
139 |
$80K |
| E0630 |
Patient lift hydraulic |
3,807 |
3,676 |
$80K |
| E2611 |
Gen use back cush wdth <22in |
1,814 |
1,694 |
$71K |
| E1028 |
W/c manual swingaway |
1,902 |
900 |
$56K |
| E0971 |
Wheelchair anti-tipping devi |
3,951 |
2,349 |
$50K |
| E2310 |
Electro connect btw control |
308 |
253 |
$43K |
| A4629 |
Tracheostomy care kit |
1,264 |
1,202 |
$42K |
| K0836 |
Pwc gp2 std sing pow opt cap |
147 |
118 |
$41K |
| E2601 |
Gen w/c cushion wdth < 22 in |
2,282 |
2,141 |
$29K |
| K0195 |
Elevating whlchair leg rests |
5,981 |
5,768 |
$27K |
| T4528 |
Adult size pull-on xl |
149 |
148 |
$26K |
| A4335 |
Incontinence supply |
4,733 |
4,679 |
$25K |
| E2361 |
22nf sealed leadacid battery |
399 |
335 |
$23K |
| E0143 |
Walker folding wheeled w/o s |
973 |
936 |
$22K |
| A7000 |
Disposable canister for pump |
2,026 |
1,952 |
$20K |
| K0861 |
Pwc gp3 std mult pow opt s/b |
34 |
28 |
$20K |
| K0007 |
Extra heavy duty wheelchair |
473 |
443 |
$20K |
| E1012 |
Ctr mount pwr elev leg rest |
122 |
104 |
$19K |
| E0185 |
Gel pressure mattress pad |
332 |
318 |
$18K |
| K0006 |
Heavy duty wheelchair |
734 |
697 |
$18K |
| A4624 |
Tracheal suction tube |
336 |
315 |
$16K |
| E0431 |
Portable gaseous 02 |
1,817 |
1,806 |
$16K |
| E2377 |
Expandable controller, initl |
147 |
124 |
$15K |
| T4535 |
Disposable liner/shield/pad |
384 |
378 |
$15K |
| E2313 |
Pwc harness, expand control |
165 |
134 |
$11K |
| A7526 |
Tracheostomy tube collar |
738 |
698 |
$10K |
| E0570 |
Nebulizer with compression |
3,689 |
3,564 |
$9K |
| A7002 |
Tubing used w suction pump |
1,713 |
1,641 |
$9K |
| E2365 |
U1 sealed leadacid battery |
240 |
204 |
$8K |
| E0600 |
Suction pump portab hom modl |
596 |
579 |
$7K |
| A4623 |
Tracheostomy inner cannula |
162 |
153 |
$7K |
| E0141 |
Rigid wheeled walker adj/fix |
486 |
457 |
$7K |
| A4628 |
Oropharyngeal suction cath |
1,150 |
1,112 |
$6K |
| E0500 |
Ippb all types |
497 |
494 |
$5K |
| E2359 |
Gr34 sealed leadacid battery |
116 |
95 |
$4K |
| K0827 |
Pwc gp vhd cap chair |
46 |
41 |
$4K |
| E0163 |
Commode chair with fixed arm |
314 |
297 |
$4K |
| A7031 |
Replacement facemask interfa |
112 |
111 |
$3K |
| E0165 |
Commode chair with detacharm |
550 |
534 |
$3K |
| E0240 |
Bath/shower chair |
35 |
35 |
$3K |
| A4216 |
Sterile water/saline, 10 ml |
342 |
333 |
$3K |
| T4544 |
Adlt disp und/pull on abv xl |
12 |
12 |
$3K |
| E0955 |
Cushioned headrest |
119 |
96 |
$2K |
| A7038 |
Pos airway pressure filter |
469 |
458 |
$2K |
| E0303 |
Hosp bed hvy dty xtra wide |
52 |
50 |
$2K |
| E0149 |
Heavy duty wheeled walker |
515 |
500 |
$2K |
| E2620 |
Wc planar back cush wd <22in |
34 |
28 |
$2K |
| E0261 |
Hosp bed semi-electr w/o mat |
41 |
37 |
$1K |
| E2624 |
Adj skin pro/pos cus<22in |
32 |
26 |
$1K |
| A4670 |
Automatic bp monitor, dial |
14 |
14 |
$738.26 |
| E2622 |
Adj skin pro w/c cus wd<22in |
14 |
12 |
$674.73 |
| K0002 |
Stnd hemi (low seat) whlchr |
37 |
37 |
$655.11 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
12 |
12 |
$632.18 |
| K0739 |
Repair/svc dme non-oxygen eq |
12 |
12 |
$379.97 |
| E0910 |
Trapeze bar attached to bed |
151 |
147 |
$314.93 |
| A4217 |
Sterile water/saline, 500 ml |
24 |
24 |
$181.21 |
| E0156 |
Walker seat attachment |
168 |
161 |
$180.59 |
| A7525 |
Tracheostomy mask |
92 |
80 |
$71.54 |
| A7012 |
Nebulizer water collec devic |
14 |
12 |
$30.71 |
| A7013 |
Disposable compressor filter |
32 |
28 |
$14.41 |
| A7015 |
Aerosol mask used w nebulize |
14 |
14 |
$8.81 |