| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,403 |
1,878 |
$1.77M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,982 |
4,305 |
$331K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,940 |
2,225 |
$210K |
| E1150 |
Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests |
4,581 |
2,543 |
$172K |
| E0430 |
Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,348 |
969 |
$99K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,968 |
1,227 |
$83K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,449 |
2,484 |
$72K |
| K0001 |
Standard wheelchair |
3,771 |
3,198 |
$53K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,793 |
1,186 |
$47K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,043 |
677 |
$35K |
| E1240 |
Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest |
128 |
69 |
$29K |
| K0003 |
Lightweight wheelchair |
1,221 |
988 |
$28K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
576 |
371 |
$13K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,624 |
2,082 |
$10K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
83 |
54 |
$9K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
53 |
24 |
$8K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,119 |
907 |
$7K |
| A4554 |
Disposable underpads, all sizes |
67 |
50 |
$7K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
133 |
59 |
$7K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
2,555 |
1,057 |
$6K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
89 |
40 |
$1K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
178 |
105 |
$785.23 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
186 |
138 |
$442.65 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
18 |
12 |
$401.42 |
| E0570 |
Nebulizer, with compressor |
40 |
25 |
$333.61 |
| A4927 |
Gloves, non-sterile, per 100 |
20 |
12 |
$130.44 |