| 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 |
3,365 |
3,223 |
$163K |
| K0001 |
Standard wheelchair |
8,470 |
8,138 |
$148K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,662 |
3,567 |
$106K |
| T4541 |
Incontinence product, disposable underpad, large, each |
9,236 |
9,039 |
$95K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
2,216 |
2,144 |
$76K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,314 |
3,241 |
$68K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,004 |
2,956 |
$66K |
| K0007 |
Extra heavy duty wheelchair |
1,155 |
1,130 |
$54K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
2,195 |
2,021 |
$46K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,172 |
3,073 |
$39K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,335 |
4,214 |
$39K |
| E0570 |
Nebulizer, with compressor |
1,037 |
1,011 |
$36K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
2,753 |
2,672 |
$36K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,339 |
3,177 |
$29K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,860 |
1,690 |
$21K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,450 |
1,444 |
$21K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
790 |
790 |
$20K |
| E0144 |
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat |
234 |
233 |
$17K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
596 |
581 |
$15K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,841 |
2,526 |
$14K |
| E0272 |
Mattress, foam rubber |
2,215 |
2,131 |
$13K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
536 |
535 |
$13K |
| E0305 |
Bed side rails, half length |
2,172 |
2,091 |
$12K |
| E0245 |
Tub stool or bench |
467 |
466 |
$11K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
1,676 |
1,446 |
$9K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
328 |
313 |
$9K |
| E2208 |
Wheelchair accessory, cylinder tank carrier, each |
2,520 |
2,403 |
$9K |
| K0003 |
Lightweight wheelchair |
202 |
200 |
$5K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
2,243 |
2,039 |
$5K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
402 |
398 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
768 |
750 |
$5K |
| 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) |
61 |
61 |
$5K |
| E1014 |
Reclining back, addition to pediatric size wheelchair |
118 |
118 |
$4K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
268 |
268 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,546 |
1,445 |
$3K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
299 |
298 |
$3K |
| E0156 |
Seat attachment, walker |
424 |
406 |
$3K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
40 |
39 |
$3K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
68 |
67 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
218 |
216 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
28 |
27 |
$549.87 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
26 |
26 |
$512.32 |
| K0006 |
Heavy duty wheelchair |
14 |
14 |
$427.30 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
66 |
66 |
$377.60 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
38 |
38 |
$282.61 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
29 |
29 |
$147.38 |
| A7030 |
Full face mask used with positive airway pressure device, each |
16 |
16 |
$135.00 |
| A7037 |
Tubing used with positive airway pressure device |
44 |
44 |
$84.72 |
| A7036 |
Chinstrap used with positive airway pressure device |
12 |
12 |
$37.03 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
33 |
33 |
$10.56 |