| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
805 |
429 |
$543K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
6,297 |
5,300 |
$204K |
| K0005 |
Ultralightweight wheelchair |
128 |
110 |
$198K |
| E0601 |
Continuous positive airway pressure (cpap) device |
9,923 |
8,365 |
$187K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,054 |
2,468 |
$88K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,587 |
2,889 |
$71K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,296 |
1,164 |
$64K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,083 |
1,590 |
$61K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
413 |
276 |
$55K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,549 |
5,835 |
$55K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,844 |
2,214 |
$54K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
890 |
520 |
$51K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,956 |
1,530 |
$51K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
35 |
25 |
$45K |
| 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) |
1,085 |
886 |
$43K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
3,503 |
2,543 |
$41K |
| E0570 |
Nebulizer, with compressor |
4,751 |
4,037 |
$35K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,492 |
1,265 |
$34K |
| A7035 |
Headgear used with positive airway pressure device |
4,367 |
3,535 |
$30K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,906 |
3,994 |
$24K |
| E1392 |
Portable oxygen concentrator, rental |
3,273 |
2,745 |
$21K |
| K0001 |
Standard wheelchair |
2,816 |
2,430 |
$21K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
408 |
294 |
$19K |
| A7037 |
Tubing used with positive airway pressure device |
1,749 |
1,363 |
$18K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
856 |
652 |
$17K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
701 |
584 |
$14K |
| E2203 |
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches |
32 |
28 |
$12K |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
118 |
103 |
$12K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,663 |
2,126 |
$11K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
978 |
858 |
$9K |
| E2613 |
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware |
39 |
28 |
$9K |
| K0003 |
Lightweight wheelchair |
661 |
592 |
$8K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
241 |
186 |
$8K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
284 |
210 |
$5K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
516 |
451 |
$4K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
153 |
57 |
$3K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
59 |
28 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
255 |
191 |
$3K |
| E0156 |
Seat attachment, walker |
229 |
178 |
$738.76 |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
22 |
14 |
$707.25 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
41 |
37 |
$545.89 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
151 |
109 |
$488.86 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
447 |
351 |
$478.18 |
| A7015 |
Aerosol mask, used with dme nebulizer |
301 |
255 |
$221.74 |
| A7036 |
Chinstrap used with positive airway pressure device |
15 |
12 |
$53.23 |