| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hosp bed semi-electr w/ matt |
3,033 |
2,568 |
$270K |
| E0601 |
Cont airway pressure device |
3,365 |
3,167 |
$230K |
| E1390 |
Oxygen concentrator |
2,107 |
1,913 |
$222K |
| K0001 |
Standard wheelchair |
3,682 |
3,263 |
$168K |
| E1392 |
Portable oxygen concentrator |
1,463 |
1,311 |
$146K |
| A7030 |
Cpap full face mask |
727 |
689 |
$96K |
| E1399 |
Durable medical equipment mi |
54 |
39 |
$83K |
| A7034 |
Nasal application device |
599 |
572 |
$55K |
| E0630 |
Patient lift hydraulic |
814 |
666 |
$54K |
| A7037 |
Pos airway pressure tubing |
1,758 |
1,682 |
$46K |
| E0971 |
Wheelchair anti-tipping devi |
1,175 |
517 |
$43K |
| A7031 |
Replacement facemask interfa |
756 |
671 |
$41K |
| K0108 |
W/c component-accessory nos |
319 |
87 |
$41K |
| A7035 |
Pos airway press headgear |
1,249 |
1,186 |
$37K |
| E0143 |
Walker folding wheeled w/o s |
460 |
413 |
$25K |
| K0006 |
Heavy duty wheelchair |
150 |
138 |
$19K |
| K0003 |
Lightweight wheelchair |
347 |
317 |
$19K |
| E2611 |
Gen use back cush wdth <22in |
102 |
91 |
$17K |
| E0562 |
Humidifier heated used w pap |
339 |
321 |
$15K |
| T4541 |
Large disposable underpad |
741 |
661 |
$15K |
| A4927 |
Non-sterile gloves |
678 |
607 |
$15K |
| A7038 |
Pos airway pressure filter |
2,496 |
2,276 |
$15K |
| A7032 |
Replacement nasal cushion |
224 |
205 |
$14K |
| K0739 |
Repair/svc dme non-oxygen eq |
243 |
163 |
$13K |
| E2601 |
Gen w/c cushion wdth < 22 in |
178 |
159 |
$8K |
| K0195 |
Elevating whlchair leg rests |
566 |
487 |
$7K |
| A7033 |
Replacement nasal pillows |
79 |
77 |
$5K |
| A7046 |
Repl water chamber, pap dev |
219 |
208 |
$4K |
| E0978 |
W/c acc,saf belt pelv strap |
127 |
89 |
$4K |
| E0431 |
Portable gaseous 02 |
74 |
74 |
$4K |
| E1028 |
W/c manual swingaway |
20 |
12 |
$4K |
| T4523 |
Adult size brief/diaper lg |
29 |
24 |
$3K |
| E0245 |
Tub stool or bench |
56 |
50 |
$3K |
| E0973 |
W/ch access det adj armrest |
21 |
12 |
$3K |
| E0443 |
Portable 02 contents, gas |
43 |
36 |
$2K |
| T4522 |
Adult size brief/diaper med |
25 |
24 |
$2K |
| E0181 |
Press pad alternating w/ pum |
104 |
98 |
$2K |
| E0156 |
Walker seat attachment |
116 |
100 |
$2K |
| E1226 |
Manual fully reclining back |
52 |
48 |
$2K |
| E0961 |
Wheelchair brake extension |
35 |
17 |
$489.73 |