| 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 |
31,138 |
20,617 |
$392K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
42,791 |
27,863 |
$327K |
| K0001 |
Standard wheelchair |
62,182 |
41,671 |
$314K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
6,530 |
4,414 |
$176K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
30,895 |
20,498 |
$161K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
5,847 |
3,540 |
$153K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
12,422 |
8,104 |
$79K |
| E0141 |
Walker, rigid, wheeled, adjustable or fixed height |
7,810 |
5,334 |
$75K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
46,276 |
32,426 |
$51K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
5,597 |
3,857 |
$45K |
| E0277 |
Powered pressure-reducing air mattress |
4,255 |
2,938 |
$34K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
11,209 |
4,320 |
$27K |
| K0003 |
Lightweight wheelchair |
4,384 |
3,187 |
$24K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
707 |
382 |
$24K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,277 |
792 |
$24K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
11,019 |
4,132 |
$22K |
| E0570 |
Nebulizer, with compressor |
17,594 |
11,726 |
$20K |
| K0006 |
Heavy duty wheelchair |
2,279 |
1,569 |
$19K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
2,544 |
1,677 |
$17K |
| E0635 |
Patient lift, electric with seat or sling |
607 |
380 |
$14K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
6,379 |
4,343 |
$12K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,067 |
1,331 |
$10K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,114 |
594 |
$9K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,548 |
1,617 |
$9K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
48 |
31 |
$5K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
3,352 |
2,193 |
$4K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
6,162 |
4,112 |
$4K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
141 |
91 |
$4K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,361 |
942 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
457 |
393 |
$3K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,137 |
899 |
$3K |
| E0156 |
Seat attachment, walker |
2,462 |
1,652 |
$2K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
308 |
188 |
$1K |
| E0601 |
Continuous positive airway pressure (cpap) device |
238 |
211 |
$914.59 |
| B9002 |
Enteral nutrition infusion pump, any type |
125 |
75 |
$861.44 |
| K0002 |
Standard hemi (low seat) wheelchair |
455 |
425 |
$602.23 |
| A7000 |
Canister, disposable, used with suction pump, each |
895 |
538 |
$350.49 |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
37 |
37 |
$198.06 |
| A7002 |
Tubing, used with suction pump, each |
1,557 |
535 |
$83.04 |
| 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) |
26 |
26 |
$18.00 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
13 |
13 |
$0.00 |