| Code | Description | Claims | Beneficiaries | Total Paid |
| E0601 |
Continuous positive airway pressure (cpap) device |
789 |
788 |
$37K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
536 |
533 |
$36K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,290 |
1,288 |
$20K |
| A7030 |
Full face mask used with positive airway pressure device, each |
133 |
132 |
$11K |
| A7037 |
Tubing used with positive airway pressure device |
668 |
663 |
$10K |
| A7035 |
Headgear used with positive airway pressure device |
707 |
700 |
$8K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
671 |
669 |
$8K |
| K0002 |
Standard hemi (low seat) wheelchair |
672 |
671 |
$6K |
| K0003 |
Lightweight wheelchair |
261 |
258 |
$5K |
| K0001 |
Standard wheelchair |
771 |
770 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,474 |
1,453 |
$4K |
| E1031 |
Rollabout chair, any and all types with casters 5" or greater |
428 |
427 |
$4K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
488 |
487 |
$4K |
| K0006 |
Heavy duty wheelchair |
195 |
195 |
$3K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
51 |
51 |
$2K |
| K0004 |
High strength, lightweight wheelchair |
162 |
162 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
748 |
738 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
155 |
148 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
54 |
52 |
$2K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
59 |
55 |
$1K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
59 |
55 |
$599.08 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
46 |
44 |
$463.26 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
25 |
25 |
$460.84 |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
26 |
26 |
$364.81 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
12 |
12 |
$314.86 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
35 |
35 |
$260.44 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
42 |
42 |
$254.26 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
60 |
56 |
$222.86 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
30 |
30 |
$141.52 |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
38 |
38 |
$0.00 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
24 |
24 |
$0.00 |