| 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 |
1,240 |
1,095 |
$94K |
| K0001 |
Standard wheelchair |
1,874 |
1,593 |
$39K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,100 |
877 |
$35K |
| E0601 |
Continuous positive airway pressure (cpap) device |
673 |
620 |
$33K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
452 |
398 |
$23K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
220 |
184 |
$18K |
| A7030 |
Full face mask used with positive airway pressure device, each |
166 |
155 |
$13K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
15 |
15 |
$11K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
736 |
674 |
$10K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
509 |
382 |
$10K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
336 |
308 |
$10K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
121 |
115 |
$8K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
321 |
283 |
$8K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
52 |
52 |
$8K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
413 |
364 |
$7K |
| E1392 |
Portable oxygen concentrator, rental |
397 |
355 |
$6K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
481 |
448 |
$6K |
| E0570 |
Nebulizer, with compressor |
304 |
276 |
$5K |
| A7031 |
Face mask interface, replacement for full face mask, each |
121 |
115 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
184 |
172 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
497 |
457 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
75 |
70 |
$3K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
13 |
13 |
$2K |
| 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) |
19 |
19 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
17 |
13 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
33 |
32 |
$2K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
45 |
37 |
$2K |
| A7526 |
Tracheostomy tube collar/holder, each |
17 |
15 |
$1K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
13 |
12 |
$1K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
13 |
13 |
$1K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
94 |
62 |
$974.06 |
| T4541 |
Incontinence product, disposable underpad, large, each |
53 |
46 |
$953.55 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
207 |
103 |
$946.23 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
23 |
14 |
$919.12 |
| A7000 |
Canister, disposable, used with suction pump, each |
29 |
28 |
$753.31 |
| A4927 |
Gloves, non-sterile, per 100 |
53 |
49 |
$712.39 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
57 |
52 |
$601.23 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
12 |
12 |
$568.25 |
| A7002 |
Tubing, used with suction pump, each |
68 |
66 |
$460.59 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
83 |
74 |
$454.59 |
| E0156 |
Seat attachment, walker |
48 |
44 |
$358.24 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
14 |
13 |
$230.05 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
37 |
35 |
$41.20 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
30 |
13 |
$40.25 |