| 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 |
2,504 |
2,399 |
$280K |
| K0001 |
Standard wheelchair |
3,985 |
3,862 |
$108K |
| A4554 |
Disposable underpads, all sizes |
1,923 |
1,891 |
$70K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
878 |
849 |
$57K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,551 |
2,446 |
$52K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
679 |
653 |
$34K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
228 |
228 |
$28K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
179 |
178 |
$21K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,999 |
1,930 |
$21K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
492 |
491 |
$18K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
100 |
100 |
$15K |
| A4335 |
Incontinence supply; miscellaneous |
2,210 |
2,169 |
$12K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
89 |
86 |
$5K |
| K0006 |
Heavy duty wheelchair |
55 |
55 |
$3K |