| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment anytype |
4,615 |
4,475 |
$1.31M |
| A4554 |
Disposable underpads |
3,521 |
3,454 |
$730K |
| A7031 |
Replacement facemask interfa |
1,749 |
1,722 |
$87K |
| A7030 |
Cpap full face mask |
542 |
536 |
$71K |
| K0001 |
Standard wheelchair |
2,328 |
2,301 |
$57K |
| A4604 |
Tubing with heating element |
789 |
786 |
$42K |
| A5120 |
Skin barrier, wipe or swab |
1,274 |
1,170 |
$41K |
| E0601 |
Cont airway pressure device |
375 |
354 |
$39K |
| E0260 |
Hosp bed semi-electr w/ matt |
763 |
752 |
$37K |
| A4927 |
Non-sterile gloves |
2,860 |
2,784 |
$37K |
| E0562 |
Humidifier heated used w pap |
681 |
650 |
$22K |
| A7038 |
Pos airway pressure filter |
2,379 |
2,362 |
$15K |
| A7032 |
Replacement nasal cushion |
331 |
322 |
$14K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
113 |
111 |
$12K |
| A7035 |
Pos airway press headgear |
381 |
379 |
$11K |
| E0143 |
Walker folding wheeled w/o s |
238 |
224 |
$10K |
| K0003 |
Lightweight wheelchair |
498 |
456 |
$8K |
| K0195 |
Elevating whlchair leg rests |
878 |
852 |
$8K |
| K0823 |
Pwc gp 2 std cap chair |
89 |
77 |
$7K |
| A7046 |
Repl water chamber, pap dev |
206 |
205 |
$3K |
| A7039 |
Filter, non disposable w pap |
228 |
224 |
$2K |
| E0261 |
Hosp bed semi-electr w/o mat |
176 |
168 |
$2K |
| E0156 |
Walker seat attachment |
149 |
135 |
$2K |
| E0240 |
Bath/shower chair |
16 |
12 |
$1K |
| E0630 |
Patient lift hydraulic |
14 |
12 |
$1K |
| A7034 |
Nasal application device |
12 |
12 |
$912.42 |
| A7033 |
Replacement nasal pillows |
38 |
37 |
$543.62 |
| E2601 |
Gen w/c cushion wdth < 22 in |
12 |
12 |
$511.83 |