| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
1,984 |
1,731 |
$691K |
| L4360 |
Pneumat walking boot pre cst |
2,789 |
2,407 |
$507K |
| K0861 |
Pwc gp3 std mult pow opt s/b |
796 |
666 |
$456K |
| K0823 |
Pwc gp 2 std cap chair |
4,515 |
3,957 |
$364K |
| K0003 |
Lightweight wheelchair |
17,599 |
15,920 |
$329K |
| E1028 |
W/c manual swingaway |
3,629 |
2,190 |
$318K |
| E0973 |
W/ch access det adj armrest |
5,239 |
3,131 |
$235K |
| K0825 |
Pwc gp 2 hd cap chair |
1,188 |
1,088 |
$196K |
| L3670 |
So acro/clav can web pre ots |
2,510 |
2,193 |
$159K |
| L3807 |
Whfo w/o joints pre cst |
1,021 |
878 |
$144K |
| E0261 |
Hosp bed semi-electr w/o mat |
7,812 |
7,184 |
$135K |
| E2611 |
Gen use back cush wdth <22in |
2,100 |
1,837 |
$132K |
| L1832 |
Ko adj jnt pos r sup pre cst |
255 |
229 |
$127K |
| E0971 |
Wheelchair anti-tipping devi |
4,337 |
2,611 |
$107K |
| E0114 |
Crutch underarm pair no wood |
3,561 |
3,327 |
$103K |
| L3908 |
Who cock-up nonmolde pre ots |
2,613 |
2,039 |
$99K |
| E0465 |
Home vent invasive interface |
112 |
68 |
$94K |
| E0245 |
Tub stool or bench |
738 |
688 |
$88K |
| K0007 |
Extra heavy duty wheelchair |
2,183 |
1,932 |
$84K |
| E0955 |
Cushioned headrest |
1,559 |
1,255 |
$83K |
| E0951 |
Loop heel |
4,299 |
2,537 |
$82K |
| E1161 |
Manual adult wc w tiltinspac |
510 |
429 |
$78K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,095 |
963 |
$63K |
| K0006 |
Heavy duty wheelchair |
2,202 |
1,910 |
$62K |
| E0143 |
Walker folding wheeled w/o s |
2,170 |
1,994 |
$61K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
316 |
271 |
$43K |
| E0630 |
Patient lift hydraulic |
1,766 |
1,624 |
$40K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,828 |
1,614 |
$36K |
| E0163 |
Commode chair with fixed arm |
1,066 |
973 |
$34K |
| K0195 |
Elevating whlchair leg rests |
1,976 |
1,728 |
$26K |
| K0005 |
Ultralightweight wheelchair |
195 |
174 |
$25K |
| E0165 |
Commode chair with detacharm |
1,572 |
1,421 |
$23K |
| E0570 |
Nebulizer with compression |
1,169 |
1,061 |
$18K |
| L1830 |
Ko immob canvas long pre ots |
418 |
388 |
$18K |
| L4350 |
Ankle control ortho pre ots |
342 |
327 |
$18K |
| E0184 |
Dry pressure mattress |
437 |
394 |
$17K |
| E0149 |
Heavy duty wheeled walker |
1,419 |
1,285 |
$15K |
| E2365 |
U1 sealed leadacid battery |
154 |
123 |
$8K |
| E0303 |
Hosp bed hvy dty xtra wide |
95 |
90 |
$7K |
| E1020 |
Residual limb support system |
340 |
251 |
$6K |
| E0910 |
Trapeze bar attached to bed |
856 |
785 |
$4K |
| E1390 |
Oxygen concentrator |
76 |
70 |
$4K |
| K0739 |
Repair/svc dme non-oxygen eq |
138 |
115 |
$4K |
| E0156 |
Walker seat attachment |
443 |
400 |
$4K |
| E2361 |
22nf sealed leadacid battery |
49 |
40 |
$3K |
| E0978 |
W/c acc,saf belt pelv strap |
58 |
50 |
$3K |
| L1902 |
Afo ankle gauntlet pre ots |
39 |
36 |
$2K |
| A7005 |
Nondisposable nebulizer set |
174 |
152 |
$2K |
| A7038 |
Pos airway pressure filter |
85 |
68 |
$1K |
| L4361 |
Pneuma/vac walk boot pre ots |
33 |
27 |
$1K |
| E2602 |
Gen w/c cushion wdth >=22 in |
18 |
12 |
$881.86 |
| A7039 |
Filter, non disposable w pap |
47 |
41 |
$495.05 |
| A7030 |
Cpap full face mask |
26 |
23 |
$286.75 |
| A7035 |
Pos airway press headgear |
29 |
24 |
$112.73 |
| A7037 |
Pos airway pressure tubing |
31 |
26 |
$109.41 |