| 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 |
11,391 |
7,717 |
$243K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,088 |
2,396 |
$64K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,861 |
4,541 |
$30K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
3,310 |
2,287 |
$19K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,773 |
1,397 |
$16K |
| A7030 |
Full face mask used with positive airway pressure device, each |
377 |
279 |
$8K |
| E1130 |
Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests |
1,632 |
1,460 |
$7K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
715 |
549 |
$6K |
| E0570 |
Nebulizer, with compressor |
2,845 |
2,225 |
$5K |
| K0001 |
Standard wheelchair |
3,055 |
2,494 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
822 |
608 |
$3K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
36 |
29 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,408 |
1,009 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
310 |
232 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
210 |
158 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
248 |
184 |
$2K |
| E1260 |
Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest |
351 |
314 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
345 |
285 |
$2K |
| K0003 |
Lightweight wheelchair |
1,043 |
900 |
$1K |
| A7035 |
Headgear used with positive airway pressure device |
308 |
231 |
$1K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
50 |
27 |
$1K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
58 |
36 |
$1K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
395 |
329 |
$501.58 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
28 |
24 |
$374.87 |
| A4452 |
Tape, waterproof, per 18 square inches |
42 |
32 |
$208.79 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
37 |
25 |
$207.21 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
46 |
36 |
$156.89 |
| E0156 |
Seat attachment, walker |
61 |
48 |
$145.30 |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
41 |
26 |
$124.12 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
52 |
41 |
$120.63 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
100 |
55 |
$108.95 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
15 |
12 |
$82.39 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
928 |
816 |
$56.05 |
| A4615 |
Cannula, nasal |
15 |
14 |
$0.00 |
| A4616 |
Tubing (oxygen), per foot |
14 |
13 |
$0.00 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
380 |
236 |
$0.00 |
| E1353 |
Regulator |
53 |
53 |
$0.00 |