| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,639 |
2,263 |
$67K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
982 |
823 |
$47K |
| K0003 |
Lightweight wheelchair |
1,606 |
1,382 |
$42K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
2,100 |
1,925 |
$19K |
| K0001 |
Standard wheelchair |
782 |
708 |
$18K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
111 |
99 |
$7K |
| E0570 |
Nebulizer, with compressor |
729 |
702 |
$5K |
| E0601 |
Continuous positive airway pressure (cpap) device |
140 |
114 |
$4K |
| T4541 |
Incontinence product, disposable underpad, large, each |
120 |
107 |
$3K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
93 |
87 |
$3K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
29 |
29 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
818 |
732 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
144 |
130 |
$1K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
29 |
29 |
$1K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
16 |
16 |
$1K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
14 |
13 |
$900.00 |
| E1392 |
Portable oxygen concentrator, rental |
40 |
36 |
$853.91 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
200 |
183 |
$555.39 |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
14 |
13 |
$450.00 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
32 |
27 |
$376.06 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
41 |
36 |
$361.87 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
16 |
12 |
$87.60 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
15 |
12 |
$8.79 |