| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0143 |
Walker folding wheeled w/o s |
3,475 |
3,359 |
$174K |
| K0001 |
Standard wheelchair |
8,704 |
8,254 |
$118K |
| E0466 |
Home vent non-invasive inter |
124 |
123 |
$99K |
| E0114 |
Crutch underarm pair no wood |
2,582 |
2,507 |
$71K |
| E0163 |
Commode chair with fixed arm |
1,069 |
1,024 |
$49K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,041 |
943 |
$49K |
| E0240 |
Bath/shower chair |
454 |
428 |
$46K |
| E0255 |
Hospital bed var ht w/ mattr |
3,175 |
3,151 |
$38K |
| E1390 |
Oxygen concentrator |
317 |
272 |
$36K |
| E0630 |
Patient lift hydraulic |
1,126 |
1,089 |
$32K |
| E0149 |
Heavy duty wheeled walker |
1,039 |
977 |
$26K |
| E0247 |
Trans bench w/wo comm open |
252 |
241 |
$26K |
| T4541 |
Large disposable underpad |
391 |
364 |
$19K |
| K0816 |
Pwc gp 1 std cap chair |
191 |
183 |
$15K |
| K0195 |
Elevating whlchair leg rests |
6,001 |
5,939 |
$12K |
| E0135 |
Walker folding adjust/fixed |
223 |
221 |
$11K |
| T4535 |
Disposable liner/shield/pad |
290 |
277 |
$9K |
| E0601 |
Cont airway pressure device |
162 |
159 |
$8K |
| K0006 |
Heavy duty wheelchair |
222 |
208 |
$7K |
| T4527 |
Adult size pull-on lg |
52 |
51 |
$6K |
| K0003 |
Lightweight wheelchair |
421 |
407 |
$6K |
| E0570 |
Nebulizer with compression |
355 |
335 |
$4K |
| E0562 |
Humidifier heated used w pap |
212 |
207 |
$4K |
| E2611 |
Gen use back cush wdth <22in |
42 |
39 |
$4K |
| T4528 |
Adult size pull-on xl |
28 |
25 |
$4K |
| E0100 |
Cane adjust/fixed with tip |
224 |
220 |
$3K |
| A4927 |
Non-sterile gloves |
303 |
285 |
$3K |
| E0156 |
Walker seat attachment |
468 |
464 |
$3K |
| E0250 |
Hosp bed fixed ht w/ mattres |
234 |
234 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
34 |
26 |
$3K |
| E2601 |
Gen w/c cushion wdth < 22 in |
98 |
93 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
74 |
63 |
$1K |
| B4034 |
Enter feed supkit syr by day |
39 |
30 |
$1K |
| B4152 |
Ef calorie dense>/=1.5kcal |
76 |
55 |
$892.36 |
| B4035 |
Enteral feed supp pump per d |
93 |
71 |
$845.77 |
| E1038 |
Transport chair pt wt<=300lb |
186 |
182 |
$443.23 |
| E0185 |
Gel pressure mattress pad |
13 |
13 |
$436.73 |
| E0244 |
Toilet seat raised |
14 |
13 |
$351.52 |
| K0002 |
Stnd hemi (low seat) whlchr |
25 |
25 |
$264.58 |
| B4087 |
Gastro/jejuno tube, std |
31 |
31 |
$5.91 |
| A7015 |
Aerosol mask used w nebulize |
53 |
39 |
$5.12 |
| A7003 |
Nebulizer administration set |
50 |
36 |
$4.50 |
| A7013 |
Disposable compressor filter |
53 |
39 |
$4.46 |