| 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 |
4,357 |
4,181 |
$427K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,048 |
938 |
$133K |
| K0003 |
Lightweight wheelchair |
941 |
853 |
$116K |
| K0001 |
Standard wheelchair |
2,509 |
2,196 |
$110K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,160 |
1,034 |
$89K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
2,854 |
1,838 |
$84K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,495 |
1,406 |
$83K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
286 |
284 |
$81K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,018 |
3,821 |
$73K |
| A7030 |
Full face mask used with positive airway pressure device, each |
439 |
432 |
$52K |
| S9999 |
Sales tax |
4,423 |
3,276 |
$39K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,372 |
742 |
$37K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
2,128 |
1,076 |
$37K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
681 |
661 |
$28K |
| A7035 |
Headgear used with positive airway pressure device |
851 |
832 |
$23K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
108 |
108 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,240 |
2,179 |
$18K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
948 |
819 |
$18K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
592 |
554 |
$17K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
264 |
254 |
$17K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
381 |
362 |
$12K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
150 |
143 |
$10K |
| E0570 |
Nebulizer, with compressor |
123 |
118 |
$9K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
170 |
154 |
$7K |
| E0156 |
Seat attachment, walker |
523 |
493 |
$6K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
13 |
12 |
$6K |
| E0184 |
Dry pressure mattress |
89 |
83 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
633 |
569 |
$5K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
24 |
13 |
$4K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
145 |
73 |
$2K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
27 |
26 |
$2K |
| E0305 |
Bed side rails, half length |
44 |
39 |
$1K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
96 |
53 |
$972.19 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
53 |
50 |
$841.66 |
| A7037 |
Tubing used with positive airway pressure device |
14 |
14 |
$352.11 |
| A4927 |
Gloves, non-sterile, per 100 |
35 |
28 |
$317.41 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
28 |
26 |
$311.18 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
19 |
12 |
$268.71 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
14 |
12 |
$113.34 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
12 |
12 |
$111.29 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
13 |
13 |
$31.78 |