| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
12,494 |
9,659 |
$367K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,543 |
3,524 |
$288K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,384 |
2,626 |
$203K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,672 |
2,059 |
$195K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,130 |
1,604 |
$123K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
930 |
705 |
$74K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,132 |
1,975 |
$70K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,117 |
868 |
$54K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
321 |
308 |
$50K |
| K0001 |
Standard wheelchair |
1,281 |
1,139 |
$27K |
| E0570 |
Nebulizer, with compressor |
1,861 |
1,641 |
$20K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,316 |
1,183 |
$18K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,135 |
1,977 |
$14K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
131 |
111 |
$9K |
| E0601 |
Continuous positive airway pressure (cpap) device |
232 |
224 |
$6K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
162 |
139 |
$5K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
192 |
170 |
$5K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
112 |
109 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
316 |
305 |
$3K |
| K0003 |
Lightweight wheelchair |
13 |
12 |
$1K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
13 |
13 |
$534.05 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
432 |
353 |
$400.45 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
12 |
12 |
$316.07 |
| A7037 |
Tubing used with positive airway pressure device |
13 |
12 |
$283.05 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
99 |
89 |
$182.74 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
27 |
26 |
$137.60 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
13 |
12 |
$97.96 |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
13 |
12 |
$65.68 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
12 |
12 |
$52.36 |