| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment anytype |
4,903 |
4,327 |
$531K |
| E1390 |
Oxygen concentrator |
4,110 |
3,634 |
$340K |
| E0601 |
Cont airway pressure device |
1,656 |
1,436 |
$81K |
| A7030 |
Cpap full face mask |
683 |
564 |
$49K |
| A4554 |
Disposable underpads |
1,882 |
1,651 |
$47K |
| E0431 |
Portable gaseous 02 |
1,234 |
1,065 |
$39K |
| A4351 |
Straight tip urine catheter |
317 |
282 |
$39K |
| E0570 |
Nebulizer with compression |
1,144 |
1,015 |
$28K |
| K0005 |
Ultralightweight wheelchair |
207 |
171 |
$26K |
| E0562 |
Humidifier heated used w pap |
275 |
213 |
$24K |
| K0861 |
Pwc gp3 std mult pow opt s/b |
36 |
36 |
$22K |
| E0260 |
Hosp bed semi-electr w/ matt |
687 |
571 |
$22K |
| K0001 |
Standard wheelchair |
1,423 |
1,182 |
$22K |
| E0603 |
Electric breast pump |
274 |
259 |
$21K |
| A7037 |
Pos airway pressure tubing |
889 |
754 |
$19K |
| A7035 |
Pos airway press headgear |
887 |
723 |
$17K |
| K0823 |
Pwc gp 2 std cap chair |
96 |
80 |
$15K |
| E1392 |
Portable oxygen concentrator |
1,057 |
933 |
$13K |
| E1028 |
W/c manual swingaway |
269 |
115 |
$12K |
| A7034 |
Nasal application device |
297 |
242 |
$12K |
| K0825 |
Pwc gp 2 hd cap chair |
43 |
37 |
$11K |
| A4604 |
Tubing with heating element |
310 |
254 |
$8K |
| A7038 |
Pos airway pressure filter |
913 |
759 |
$6K |
| E0143 |
Walker folding wheeled w/o s |
186 |
140 |
$6K |
| E0114 |
Crutch underarm pair no wood |
159 |
129 |
$5K |
| K0195 |
Elevating whlchair leg rests |
485 |
390 |
$4K |
| T4535 |
Disposable liner/shield/pad |
125 |
108 |
$2K |
| E0630 |
Patient lift hydraulic |
71 |
66 |
$2K |
| A7005 |
Nondisposable nebulizer set |
70 |
60 |
$1K |
| E0973 |
W/ch access det adj armrest |
21 |
13 |
$1K |
| K0108 |
W/c component-accessory nos |
28 |
14 |
$802.10 |
| E2361 |
22nf sealed leadacid battery |
16 |
12 |
$739.58 |
| K0739 |
Repair/svc dme non-oxygen eq |
38 |
29 |
$558.83 |
| E0955 |
Cushioned headrest |
28 |
24 |
$528.72 |
| A7031 |
Replacement facemask interfa |
58 |
46 |
$432.72 |
| A7046 |
Repl water chamber, pap dev |
77 |
66 |
$345.37 |