| 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 |
12,470 |
10,897 |
$822K |
| T4541 |
Incontinence product, disposable underpad, large, each |
7,538 |
6,435 |
$233K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,864 |
2,437 |
$207K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,831 |
1,555 |
$163K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
3,568 |
2,793 |
$140K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,959 |
1,642 |
$132K |
| K0816 |
Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,083 |
949 |
$125K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,892 |
8,562 |
$118K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,418 |
2,906 |
$83K |
| E0570 |
Nebulizer, with compressor |
3,357 |
3,093 |
$27K |
| K0001 |
Standard wheelchair |
1,423 |
1,250 |
$17K |
| E0601 |
Continuous positive airway pressure (cpap) device |
386 |
351 |
$13K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
469 |
413 |
$6K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
516 |
474 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
194 |
170 |
$5K |
| K0800 |
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds |
17 |
13 |
$4K |
| A7030 |
Full face mask used with positive airway pressure device, each |
43 |
41 |
$4K |
| A7037 |
Tubing used with positive airway pressure device |
166 |
152 |
$3K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
168 |
142 |
$3K |
| 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) |
39 |
37 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
134 |
127 |
$2K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
13 |
12 |
$2K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
119 |
92 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
350 |
290 |
$759.40 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
32 |
26 |
$618.51 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
54 |
38 |
$606.06 |
| E0156 |
Seat attachment, walker |
157 |
137 |
$429.81 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
87 |
84 |
$406.56 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
13 |
12 |
$60.17 |
| A4616 |
Tubing (oxygen), per foot |
12 |
12 |
$0.00 |