| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
333 |
333 |
$63K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,768 |
2,718 |
$57K |
| K0001 |
Standard wheelchair |
2,653 |
2,614 |
$41K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
19 |
18 |
$35K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
691 |
689 |
$23K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
121 |
65 |
$23K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
296 |
194 |
$22K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,347 |
2,299 |
$19K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
780 |
487 |
$17K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
952 |
941 |
$14K |
| K0003 |
Lightweight wheelchair |
544 |
530 |
$14K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
402 |
396 |
$12K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
370 |
365 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
519 |
518 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
761 |
752 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,503 |
1,481 |
$6K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
36 |
26 |
$6K |
| A7030 |
Full face mask used with positive airway pressure device, each |
178 |
176 |
$5K |
| E2613 |
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware |
16 |
14 |
$5K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
140 |
140 |
$5K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
212 |
210 |
$5K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
15 |
14 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
408 |
404 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
141 |
137 |
$3K |
| E0570 |
Nebulizer, with compressor |
348 |
335 |
$3K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
32 |
29 |
$3K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
51 |
50 |
$3K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
31 |
15 |
$2K |
| K0040 |
Adjustable angle footplate, each |
17 |
15 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
72 |
61 |
$2K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
13 |
12 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
85 |
81 |
$2K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
158 |
150 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
132 |
131 |
$2K |
| A7000 |
Canister, disposable, used with suction pump, each |
247 |
234 |
$1K |
| A7002 |
Tubing, used with suction pump, each |
320 |
296 |
$1K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
107 |
101 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
184 |
182 |
$1K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
17 |
17 |
$903.23 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
28 |
24 |
$882.26 |
| A7526 |
Tracheostomy tube collar/holder, each |
40 |
39 |
$790.39 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
16 |
15 |
$539.39 |
| E0156 |
Seat attachment, walker |
52 |
52 |
$251.77 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
12 |
12 |
$173.30 |
| 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) |
24 |
24 |
$113.97 |