| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
20,880 |
18,087 |
$561K |
| T4541 |
Large disposable underpad |
4,836 |
4,543 |
$184K |
| K0001 |
Standard wheelchair |
23,443 |
20,094 |
$146K |
| E0431 |
Portable gaseous 02 |
17,744 |
15,420 |
$104K |
| E0260 |
Hosp bed semi-electr w/ matt |
7,609 |
6,456 |
$101K |
| T4527 |
Adult size pull-on lg |
1,286 |
1,225 |
$85K |
| T4528 |
Adult size pull-on xl |
1,010 |
957 |
$83K |
| E0250 |
Hosp bed fixed ht w/ mattres |
6,794 |
5,849 |
$81K |
| K0823 |
Pwc gp 2 std cap chair |
1,111 |
930 |
$77K |
| T4526 |
Adult size pull-on med |
1,160 |
1,132 |
$75K |
| T4523 |
Adult size brief/diaper lg |
1,027 |
966 |
$73K |
| E0630 |
Patient lift hydraulic |
5,180 |
4,414 |
$66K |
| K0816 |
Pwc gp 1 std cap chair |
1,530 |
1,304 |
$58K |
| T4524 |
Adult size brief/diaper xl |
608 |
581 |
$52K |
| T4543 |
Adult disp brief/diap abv xl |
239 |
225 |
$40K |
| E0185 |
Gel pressure mattress pad |
1,118 |
970 |
$40K |
| E0277 |
Powered pres-redu air mattrs |
378 |
316 |
$38K |
| A4351 |
Straight tip urine catheter |
336 |
321 |
$37K |
| K0006 |
Heavy duty wheelchair |
1,864 |
1,599 |
$36K |
| E0143 |
Walker folding wheeled w/o s |
2,421 |
2,059 |
$35K |
| K0007 |
Extra heavy duty wheelchair |
979 |
849 |
$32K |
| K0003 |
Lightweight wheelchair |
2,732 |
2,286 |
$31K |
| K0195 |
Elevating whlchair leg rests |
8,866 |
7,603 |
$28K |
| E2601 |
Gen w/c cushion wdth < 22 in |
2,385 |
2,004 |
$27K |
| E0570 |
Nebulizer with compression |
6,113 |
5,276 |
$23K |
| A4927 |
Non-sterile gloves |
3,595 |
2,534 |
$17K |
| E0255 |
Hospital bed var ht w/ mattr |
1,559 |
1,335 |
$17K |
| T4522 |
Adult size brief/diaper med |
176 |
166 |
$15K |
| A4623 |
Tracheostomy inner cannula |
266 |
226 |
$14K |
| E0163 |
Commode chair with fixed arm |
712 |
581 |
$9K |
| E0156 |
Walker seat attachment |
1,390 |
1,156 |
$5K |
| E0910 |
Trapeze bar attached to bed |
1,872 |
1,643 |
$5K |
| K0825 |
Pwc gp 2 hd cap chair |
30 |
24 |
$4K |
| E1225 |
Manual semi-reclining back |
574 |
478 |
$4K |
| K0002 |
Stnd hemi (low seat) whlchr |
345 |
285 |
$4K |
| A4629 |
Tracheostomy care kit |
118 |
97 |
$4K |
| T4535 |
Disposable liner/shield/pad |
52 |
50 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
2,335 |
1,897 |
$2K |
| E0165 |
Commode chair with detacharm |
410 |
336 |
$2K |
| E1038 |
Transport chair pt wt<=300lb |
352 |
312 |
$1K |
| K0800 |
Pov group 1 std up to 300lbs |
130 |
115 |
$1K |
| E0600 |
Suction pump portab hom modl |
205 |
175 |
$1K |
| E0261 |
Hosp bed semi-electr w/o mat |
58 |
55 |
$1K |
| E0966 |
Wheelchair head rest extensi |
793 |
676 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
178 |
175 |
$1K |
| E2365 |
U1 sealed leadacid battery |
19 |
13 |
$941.96 |
| A4349 |
Disposable male external cat |
26 |
24 |
$748.74 |
| A7003 |
Nebulizer administration set |
631 |
553 |
$651.63 |
| A7526 |
Tracheostomy tube collar |
34 |
25 |
$636.56 |
| A4402 |
Lubricant per ounce |
130 |
123 |
$434.97 |
| A7000 |
Disposable canister for pump |
27 |
24 |
$285.74 |
| E0565 |
Compressor air power source |
27 |
25 |
$239.28 |
| A4435 |
1pc ost pch drain hgh output |
53 |
37 |
$185.15 |
| K0738 |
Portable gas oxygen system |
45 |
36 |
$167.22 |
| A4357 |
Bedside drainage bag |
13 |
12 |
$113.60 |
| E0978 |
W/c acc,saf belt pelv strap |
27 |
24 |
$39.18 |
| A7002 |
Tubing used w suction pump |
15 |
13 |
$31.85 |