| 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 |
54,262 |
47,515 |
$2.93M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
16,957 |
14,216 |
$181K |
| E1392 |
Portable oxygen concentrator, rental |
10,650 |
7,721 |
$170K |
| K0001 |
Standard wheelchair |
5,005 |
4,479 |
$68K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,116 |
2,738 |
$65K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,115 |
886 |
$63K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,555 |
2,029 |
$63K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
797 |
650 |
$55K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,207 |
945 |
$43K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
299 |
209 |
$32K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
660 |
538 |
$28K |
| E0245 |
Tub stool or bench |
722 |
536 |
$22K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
775 |
648 |
$22K |
| A7035 |
Headgear used with positive airway pressure device |
1,508 |
1,215 |
$20K |
| A7037 |
Tubing used with positive airway pressure device |
1,036 |
871 |
$18K |
| K0006 |
Heavy duty wheelchair |
601 |
471 |
$18K |
| E0570 |
Nebulizer, with compressor |
1,494 |
1,237 |
$16K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,601 |
2,867 |
$15K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
85 |
72 |
$14K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
869 |
652 |
$13K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
493 |
434 |
$13K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
376 |
322 |
$9K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,142 |
1,869 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
560 |
508 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
951 |
804 |
$8K |
| E0156 |
Seat attachment, walker |
761 |
498 |
$7K |
| K0003 |
Lightweight wheelchair |
509 |
369 |
$6K |
| A4554 |
Disposable underpads, all sizes |
172 |
132 |
$6K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
323 |
285 |
$6K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
963 |
824 |
$5K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
410 |
182 |
$5K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
89 |
80 |
$4K |
| E0244 |
Raised toilet seat |
252 |
161 |
$4K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
58 |
52 |
$4K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
210 |
188 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
42 |
38 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
124 |
67 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
181 |
86 |
$795.95 |
| A4927 |
Gloves, non-sterile, per 100 |
51 |
49 |
$678.48 |
| 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) |
13 |
12 |
$529.98 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
43 |
39 |
$509.58 |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
14 |
12 |
$471.96 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
105 |
95 |
$273.33 |
| E0241 |
Bath tub wall rail, each |
24 |
12 |
$233.94 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
24 |
24 |
$218.41 |
| S8120 |
Oxygen contents, gaseous, 1 unit equals 1 cubic foot |
522 |
370 |
$0.00 |