| 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 |
10,032 |
7,690 |
$334K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,217 |
6,366 |
$136K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,056 |
2,488 |
$63K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,567 |
1,993 |
$39K |
| A7030 |
Full face mask used with positive airway pressure device, each |
711 |
541 |
$37K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
336 |
287 |
$35K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
308 |
275 |
$33K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
294 |
249 |
$32K |
| T4541 |
Incontinence product, disposable underpad, large, each |
700 |
592 |
$30K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,003 |
715 |
$28K |
| K0001 |
Standard wheelchair |
4,341 |
3,665 |
$24K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
849 |
723 |
$21K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,513 |
1,256 |
$20K |
| E0245 |
Tub stool or bench |
339 |
275 |
$20K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,023 |
834 |
$20K |
| E0570 |
Nebulizer, with compressor |
3,079 |
2,518 |
$15K |
| E0277 |
Powered pressure-reducing air mattress |
267 |
227 |
$14K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
119 |
94 |
$13K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
332 |
261 |
$12K |
| A7031 |
Face mask interface, replacement for full face mask, each |
556 |
434 |
$11K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
3,256 |
2,814 |
$11K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
628 |
441 |
$11K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
156 |
114 |
$9K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
320 |
256 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
684 |
529 |
$7K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
72 |
63 |
$7K |
| E1392 |
Portable oxygen concentrator, rental |
677 |
444 |
$7K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
306 |
229 |
$7K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
442 |
355 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
701 |
528 |
$6K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
187 |
171 |
$6K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
633 |
527 |
$4K |
| K0006 |
Heavy duty wheelchair |
380 |
299 |
$4K |
| 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) |
73 |
49 |
$4K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
50 |
37 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
393 |
315 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
113 |
95 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
443 |
354 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,064 |
830 |
$3K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
94 |
78 |
$3K |
| E0156 |
Seat attachment, walker |
556 |
439 |
$2K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
324 |
277 |
$2K |
| A9281 |
Reaching/grabbing device, any type, any length, each |
25 |
25 |
$2K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
240 |
222 |
$1K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
121 |
109 |
$1K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
62 |
42 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
155 |
127 |
$1K |
| K0003 |
Lightweight wheelchair |
171 |
151 |
$1K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
16 |
12 |
$926.31 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
34 |
26 |
$624.33 |
| E0244 |
Raised toilet seat |
13 |
12 |
$572.00 |
| K0002 |
Standard hemi (low seat) wheelchair |
48 |
40 |
$545.04 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
54 |
52 |
$419.57 |
| A4259 |
Lancets, per box of 100 |
76 |
73 |
$355.94 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
75 |
60 |
$284.66 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
114 |
87 |
$262.47 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
81 |
70 |
$93.82 |