| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,169 |
2,889 |
$332K |
| K0001 |
Standard wheelchair |
11,814 |
11,082 |
$214K |
| E0143 |
Walker folding wheeled w/o s |
3,804 |
3,531 |
$177K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,525 |
1,434 |
$158K |
| E0163 |
Commode chair with fixed arm |
1,778 |
1,641 |
$57K |
| K0003 |
Lightweight wheelchair |
1,563 |
1,473 |
$53K |
| E0245 |
Tub stool or bench |
869 |
752 |
$53K |
| K0195 |
Elevating whlchair leg rests |
4,513 |
4,218 |
$50K |
| E0570 |
Nebulizer with compression |
2,828 |
2,609 |
$41K |
| E0431 |
Portable gaseous 02 |
3,016 |
2,699 |
$28K |
| K0007 |
Extra heavy duty wheelchair |
571 |
544 |
$24K |
| K0006 |
Heavy duty wheelchair |
614 |
573 |
$23K |
| E0443 |
Portable 02 contents, gas |
833 |
771 |
$19K |
| A7526 |
Tracheostomy tube collar |
272 |
254 |
$15K |
| E2601 |
Gen w/c cushion wdth < 22 in |
520 |
469 |
$14K |
| E0240 |
Bath/shower chair |
266 |
201 |
$11K |
| E0600 |
Suction pump portab hom modl |
580 |
547 |
$10K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
78 |
70 |
$6K |
| E0156 |
Walker seat attachment |
641 |
595 |
$5K |
| E0971 |
Wheelchair anti-tipping devi |
1,015 |
938 |
$5K |
| A4623 |
Tracheostomy inner cannula |
40 |
38 |
$5K |
| E0978 |
W/c acc,saf belt pelv strap |
2,406 |
2,261 |
$3K |
| A7000 |
Disposable canister for pump |
326 |
302 |
$2K |
| E0165 |
Commode chair with detacharm |
66 |
64 |
$2K |
| A7002 |
Tubing used w suction pump |
381 |
363 |
$2K |
| E0149 |
Heavy duty wheeled walker |
595 |
554 |
$2K |
| A4629 |
Tracheostomy care kit |
13 |
12 |
$1K |
| E1038 |
Transport chair pt wt<=300lb |
209 |
196 |
$947.34 |
| A4628 |
Oropharyngeal suction cath |
96 |
87 |
$727.32 |
| E0961 |
Wheelchair brake extension |
330 |
293 |
$548.15 |
| A7005 |
Nondisposable nebulizer set |
44 |
41 |
$429.13 |
| E0433 |
Portable liquid oxygen sys |
12 |
12 |
$332.20 |
| A7015 |
Aerosol mask used w nebulize |
280 |
254 |
$242.92 |
| A7003 |
Nebulizer administration set |
125 |
121 |
$196.13 |