| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
1,898 |
1,889 |
$186K |
| T4522 |
Adult size brief/diaper med |
1,332 |
1,330 |
$177K |
| K0001 |
Standard wheelchair |
7,894 |
7,705 |
$113K |
| E1390 |
Oxygen concentrator |
3,089 |
2,907 |
$98K |
| T4526 |
Adult size pull-on med |
594 |
593 |
$67K |
| K0003 |
Lightweight wheelchair |
3,639 |
3,621 |
$65K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,714 |
2,653 |
$59K |
| E0973 |
W/ch access det adj armrest |
1,487 |
1,456 |
$53K |
| T4535 |
Disposable liner/shield/pad |
656 |
655 |
$53K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
504 |
501 |
$49K |
| K0002 |
Stnd hemi (low seat) whlchr |
1,827 |
1,823 |
$44K |
| K0007 |
Extra heavy duty wheelchair |
1,059 |
1,058 |
$41K |
| E2611 |
Gen use back cush wdth <22in |
586 |
566 |
$31K |
| E1226 |
Manual fully reclining back |
212 |
209 |
$21K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,264 |
1,235 |
$20K |
| E0143 |
Walker folding wheeled w/o s |
892 |
859 |
$19K |
| K0195 |
Elevating whlchair leg rests |
4,222 |
4,180 |
$18K |
| E0431 |
Portable gaseous 02 |
3,048 |
2,857 |
$16K |
| E0971 |
Wheelchair anti-tipping devi |
1,393 |
1,366 |
$13K |
| K0823 |
Pwc gp 2 std cap chair |
236 |
229 |
$13K |
| E0961 |
Wheelchair brake extension |
1,373 |
1,348 |
$12K |
| E0245 |
Tub stool or bench |
213 |
213 |
$12K |
| E0978 |
W/c acc,saf belt pelv strap |
1,314 |
1,291 |
$10K |
| E0373 |
Nonpowered pressure mattress |
91 |
85 |
$4K |
| E0185 |
Gel pressure mattress pad |
77 |
74 |
$3K |
| E0951 |
Loop heel |
684 |
661 |
$3K |
| E0570 |
Nebulizer with compression |
631 |
623 |
$2K |
| E0630 |
Patient lift hydraulic |
114 |
114 |
$2K |
| E0156 |
Walker seat attachment |
257 |
246 |
$1K |
| E0163 |
Commode chair with fixed arm |
14 |
13 |
$218.62 |