| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,785 |
1,765 |
$648K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,948 |
4,866 |
$82K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,299 |
2,276 |
$76K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
9,718 |
9,605 |
$65K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
257 |
227 |
$40K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
6,116 |
6,016 |
$33K |
| K0001 |
Standard wheelchair |
7,278 |
7,118 |
$27K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
1,321 |
1,298 |
$23K |
| E0570 |
Nebulizer, with compressor |
3,386 |
3,348 |
$17K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,435 |
2,408 |
$17K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,365 |
1,336 |
$12K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,325 |
2,294 |
$10K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
816 |
807 |
$10K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,287 |
2,248 |
$9K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,041 |
5,962 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
3,212 |
3,173 |
$8K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
208 |
206 |
$7K |
| E0245 |
Tub stool or bench |
323 |
319 |
$6K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
198 |
172 |
$6K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
813 |
802 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,935 |
4,783 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
731 |
718 |
$4K |
| A7037 |
Tubing used with positive airway pressure device |
1,504 |
1,469 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,123 |
1,115 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,544 |
1,540 |
$2K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
3,268 |
3,209 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,332 |
2,307 |
$1K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
607 |
583 |
$1K |
| K0003 |
Lightweight wheelchair |
454 |
438 |
$1K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
27 |
27 |
$1K |
| E0271 |
Mattress, innerspring |
239 |
235 |
$874.47 |
| E0305 |
Bed side rails, half length |
202 |
197 |
$571.64 |
| E0156 |
Seat attachment, walker |
479 |
467 |
$444.09 |
| K0006 |
Heavy duty wheelchair |
36 |
36 |
$344.02 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
20 |
19 |
$206.65 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
27 |
26 |
$134.15 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
16 |
16 |
$121.19 |
| A7015 |
Aerosol mask, used with dme nebulizer |
201 |
198 |
$57.84 |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
13 |
12 |
$28.75 |
| E1355 |
Stand/rack |
46 |
46 |
$24.84 |