| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
3,853 |
3,721 |
$155K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,352 |
1,303 |
$105K |
| K0003 |
Lightweight wheelchair |
1,676 |
1,595 |
$59K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
906 |
852 |
$53K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,264 |
1,190 |
$53K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,650 |
1,569 |
$45K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,185 |
1,134 |
$42K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,115 |
2,029 |
$41K |
| A7035 |
Headgear used with positive airway pressure device |
3,017 |
2,890 |
$28K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,136 |
2,946 |
$18K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
257 |
250 |
$14K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,013 |
937 |
$11K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
362 |
340 |
$11K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
187 |
89 |
$8K |
| A7037 |
Tubing used with positive airway pressure device |
849 |
792 |
$5K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
70 |
61 |
$4K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
66 |
65 |
$2K |
| E2228 |
Manual wheelchair accessory, wheel braking system and lock, complete, each |
39 |
28 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
342 |
330 |
$2K |
| A7036 |
Chinstrap used with positive airway pressure device |
232 |
221 |
$1K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
69 |
59 |
$1K |
| E0561 |
Humidifier, non-heated, used with positive airway pressure device |
145 |
143 |
$668.70 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
16 |
14 |
$558.78 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
19 |
15 |
$282.72 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
161 |
154 |
$189.00 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
17 |
14 |
$171.46 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
19 |
15 |
$155.02 |
| E0167 |
Pail or pan for use with commode chair, replacement only |
27 |
27 |
$0.00 |