| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
11,539 |
10,366 |
$817K |
| A7030 |
Full face mask used with positive airway pressure device, each |
8,107 |
7,382 |
$645K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
6,455 |
5,827 |
$538K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
14,064 |
11,840 |
$532K |
| A7031 |
Face mask interface, replacement for full face mask, each |
14,538 |
12,881 |
$517K |
| E0570 |
Nebulizer, with compressor |
15,693 |
14,060 |
$333K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
8,894 |
7,809 |
$289K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,956 |
3,586 |
$219K |
| A7037 |
Tubing used with positive airway pressure device |
10,661 |
9,756 |
$209K |
| 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) |
1,333 |
1,175 |
$195K |
| K0003 |
Lightweight wheelchair |
7,855 |
6,687 |
$185K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
3,676 |
3,284 |
$171K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
4,334 |
3,807 |
$152K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
22,205 |
20,214 |
$145K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,515 |
2,299 |
$144K |
| A7035 |
Headgear used with positive airway pressure device |
6,744 |
6,142 |
$121K |
| K0001 |
Standard wheelchair |
11,587 |
10,170 |
$119K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
3,149 |
2,693 |
$81K |
| K0006 |
Heavy duty wheelchair |
2,450 |
2,122 |
$68K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,805 |
1,619 |
$58K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
2,524 |
2,200 |
$48K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,563 |
9,620 |
$43K |
| K0007 |
Extra heavy duty wheelchair |
1,678 |
1,456 |
$41K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
216 |
161 |
$36K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
851 |
556 |
$33K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,851 |
2,469 |
$33K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
330 |
285 |
$31K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
45 |
45 |
$27K |
| T4541 |
Incontinence product, disposable underpad, large, each |
176 |
173 |
$26K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
481 |
403 |
$26K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
3,862 |
3,536 |
$23K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
920 |
435 |
$22K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
45 |
43 |
$20K |
| E0156 |
Seat attachment, walker |
3,064 |
2,714 |
$20K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
344 |
259 |
$19K |
| E2202 |
Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches |
769 |
674 |
$17K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
1,336 |
1,195 |
$17K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
269 |
222 |
$15K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
731 |
594 |
$15K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,042 |
763 |
$12K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
28 |
24 |
$11K |
| E0168 |
Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each |
1,008 |
917 |
$10K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
398 |
257 |
$10K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
941 |
446 |
$10K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
6,645 |
6,186 |
$10K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
988 |
759 |
$9K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
2,387 |
2,119 |
$8K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
44 |
44 |
$7K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
381 |
324 |
$7K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
13 |
13 |
$6K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
15 |
15 |
$6K |
| E0277 |
Powered pressure-reducing air mattress |
115 |
95 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
398 |
348 |
$3K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
754 |
293 |
$3K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
30 |
26 |
$3K |
| K0800 |
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds |
16 |
16 |
$2K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
64 |
57 |
$2K |
| E0271 |
Mattress, innerspring |
164 |
153 |
$2K |
| E0310 |
Bed side rails, full length |
1,079 |
1,011 |
$2K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
321 |
272 |
$1K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
257 |
236 |
$1K |
| A7036 |
Chinstrap used with positive airway pressure device |
126 |
107 |
$952.66 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
29 |
24 |
$659.57 |
| B9002 |
Enteral nutrition infusion pump, any type |
53 |
38 |
$570.89 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
16 |
12 |
$159.20 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
17 |
15 |
$122.66 |