| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
3,985 |
3,422 |
$249K |
| K0003 |
Lightweight wheelchair |
3,921 |
3,041 |
$182K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,087 |
2,432 |
$155K |
| K0004 |
High strength ltwt whlchr |
1,710 |
1,458 |
$94K |
| A7030 |
Cpap full face mask |
810 |
707 |
$92K |
| A4554 |
Disposable underpads |
1,456 |
1,276 |
$77K |
| A7034 |
Nasal application device |
765 |
666 |
$57K |
| E0630 |
Patient lift hydraulic |
673 |
517 |
$53K |
| E0971 |
Wheelchair anti-tipping devi |
1,984 |
1,135 |
$52K |
| E0143 |
Walker folding wheeled w/o s |
951 |
822 |
$49K |
| K0001 |
Standard wheelchair |
2,220 |
1,760 |
$35K |
| E0265 |
Hosp bed total electr w/ mat |
200 |
176 |
$34K |
| A7031 |
Replacement facemask interfa |
706 |
621 |
$32K |
| A7035 |
Pos airway press headgear |
1,486 |
1,294 |
$32K |
| A4604 |
Tubing with heating element |
1,115 |
967 |
$31K |
| E0247 |
Trans bench w/wo comm open |
376 |
311 |
$28K |
| E0165 |
Commode chair with detacharm |
1,415 |
1,088 |
$26K |
| K0823 |
Pwc gp 2 std cap chair |
84 |
64 |
$18K |
| K0007 |
Extra heavy duty wheelchair |
119 |
102 |
$17K |
| E0562 |
Humidifier heated used w pap |
95 |
78 |
$17K |
| E0973 |
W/ch access det adj armrest |
235 |
117 |
$14K |
| A7037 |
Pos airway pressure tubing |
424 |
378 |
$14K |
| A7038 |
Pos airway pressure filter |
2,227 |
1,929 |
$13K |
| K0195 |
Elevating whlchair leg rests |
1,131 |
877 |
$12K |
| K0006 |
Heavy duty wheelchair |
152 |
105 |
$10K |
| E2601 |
Gen w/c cushion wdth < 22 in |
339 |
276 |
$7K |
| A7032 |
Replacement nasal cushion |
144 |
130 |
$7K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
38 |
27 |
$6K |
| A7046 |
Repl water chamber, pap dev |
391 |
351 |
$4K |
| E1020 |
Residual limb support system |
182 |
147 |
$4K |
| T4528 |
Adult size pull-on xl |
31 |
24 |
$4K |
| A7033 |
Replacement nasal pillows |
109 |
90 |
$3K |
| T4527 |
Adult size pull-on lg |
39 |
26 |
$3K |
| E0163 |
Commode chair with fixed arm |
51 |
39 |
$2K |
| E0240 |
Bath/shower chair |
33 |
25 |
$2K |
| E0570 |
Nebulizer with compression |
32 |
28 |
$2K |
| E0951 |
Loop heel |
211 |
97 |
$1K |
| E2611 |
Gen use back cush wdth <22in |
17 |
12 |
$1K |
| E1390 |
Oxygen concentrator |
15 |
13 |
$543.44 |
| E0978 |
W/c acc,saf belt pelv strap |
20 |
12 |
$494.13 |
| E0294 |
Hosp bed semi-elect w/ mattr |
32 |
24 |
$187.41 |