| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
14,870 |
14,794 |
$882K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,020 |
4,007 |
$294K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
6,623 |
6,580 |
$291K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
10,314 |
10,206 |
$284K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,475 |
4,455 |
$273K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
6,955 |
6,842 |
$213K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,976 |
1,965 |
$152K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,562 |
1,552 |
$151K |
| K0001 |
Standard wheelchair |
10,077 |
9,960 |
$121K |
| K0003 |
Lightweight wheelchair |
4,963 |
4,912 |
$86K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,975 |
2,948 |
$86K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
5,314 |
5,278 |
$83K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
3,833 |
3,811 |
$83K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
1,386 |
1,365 |
$70K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
1,067 |
1,049 |
$68K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,924 |
2,883 |
$54K |
| E0272 |
Mattress, foam rubber |
1,071 |
1,063 |
$53K |
| E1031 |
Rollabout chair, any and all types with casters 5" or greater |
3,485 |
3,454 |
$48K |
| E0310 |
Bed side rails, full length |
1,162 |
1,154 |
$47K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
484 |
483 |
$41K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
656 |
654 |
$39K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,952 |
5,831 |
$35K |
| E0245 |
Tub stool or bench |
629 |
624 |
$35K |
| A4335 |
Incontinence supply; miscellaneous |
4,590 |
4,576 |
$33K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,387 |
1,353 |
$32K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
831 |
819 |
$15K |
| E0277 |
Powered pressure-reducing air mattress |
734 |
725 |
$13K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,526 |
2,506 |
$11K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,006 |
987 |
$10K |
| E0570 |
Nebulizer, with compressor |
4,454 |
4,388 |
$9K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,169 |
1,151 |
$9K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
287 |
274 |
$9K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
389 |
380 |
$5K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
293 |
287 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
555 |
555 |
$3K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
426 |
420 |
$3K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
334 |
329 |
$3K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
26 |
25 |
$2K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
113 |
113 |
$1K |
| K0006 |
Heavy duty wheelchair |
38 |
38 |
$896.55 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
92 |
92 |
$835.74 |
| K0004 |
High strength, lightweight wheelchair |
72 |
72 |
$766.44 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
134 |
133 |
$545.67 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
27 |
27 |
$296.52 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
13 |
13 |
$215.48 |
| E0156 |
Seat attachment, walker |
25 |
25 |
$65.94 |