| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
7,419 |
6,797 |
$368K |
| K0003 |
Lightweight wheelchair |
13,363 |
12,714 |
$352K |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
205 |
165 |
$337K |
| E0277 |
Powered pressure-reducing air mattress |
2,132 |
2,020 |
$317K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
5,898 |
5,573 |
$227K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
2,073 |
1,841 |
$179K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,299 |
1,192 |
$166K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
606 |
463 |
$138K |
| A4554 |
Disposable underpads, all sizes |
3,868 |
3,831 |
$138K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
5,968 |
3,394 |
$132K |
| E1002 |
Wheelchair accessory, power seating system, tilt only |
290 |
238 |
$120K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,341 |
2,326 |
$97K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
645 |
637 |
$87K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
6,620 |
6,503 |
$86K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
695 |
690 |
$83K |
| K0001 |
Standard wheelchair |
12,761 |
12,468 |
$82K |
| E2311 |
Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware |
167 |
139 |
$80K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
3,807 |
3,676 |
$80K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
1,814 |
1,694 |
$71K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,902 |
900 |
$56K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
3,951 |
2,349 |
$50K |
| E2310 |
Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware |
308 |
253 |
$43K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
1,264 |
1,202 |
$42K |
| K0836 |
Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds |
147 |
118 |
$41K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
2,282 |
2,141 |
$29K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
5,981 |
5,768 |
$27K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
149 |
148 |
$26K |
| A4335 |
Incontinence supply; miscellaneous |
4,733 |
4,679 |
$25K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
399 |
335 |
$23K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
973 |
936 |
$22K |
| A7000 |
Canister, disposable, used with suction pump, each |
2,026 |
1,952 |
$20K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
34 |
28 |
$20K |
| K0007 |
Extra heavy duty wheelchair |
473 |
443 |
$20K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
122 |
104 |
$19K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
332 |
318 |
$18K |
| K0006 |
Heavy duty wheelchair |
734 |
697 |
$18K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
336 |
315 |
$16K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,817 |
1,806 |
$16K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
147 |
124 |
$15K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
384 |
378 |
$15K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
165 |
134 |
$11K |
| A7526 |
Tracheostomy tube collar/holder, each |
738 |
698 |
$10K |
| E0570 |
Nebulizer, with compressor |
3,689 |
3,564 |
$9K |
| A7002 |
Tubing, used with suction pump, each |
1,713 |
1,641 |
$9K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
240 |
204 |
$8K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
596 |
579 |
$7K |
| A4623 |
Tracheostomy, inner cannula |
162 |
153 |
$7K |
| E0141 |
Walker, rigid, wheeled, adjustable or fixed height |
486 |
457 |
$7K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,150 |
1,112 |
$6K |
| E0500 |
Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source |
497 |
494 |
$5K |
| E2359 |
Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
116 |
95 |
$4K |
| K0827 |
Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds |
46 |
41 |
$4K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
314 |
297 |
$4K |
| A7031 |
Face mask interface, replacement for full face mask, each |
112 |
111 |
$3K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
550 |
534 |
$3K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
35 |
35 |
$3K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
342 |
333 |
$3K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
12 |
12 |
$3K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
119 |
96 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
469 |
458 |
$2K |
| 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 |
52 |
50 |
$2K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
515 |
500 |
$2K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
34 |
28 |
$2K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
41 |
37 |
$1K |
| E2624 |
Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
32 |
26 |
$1K |
| A4670 |
Automatic blood pressure monitor |
14 |
14 |
$738.26 |
| E2622 |
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
14 |
12 |
$674.73 |
| K0002 |
Standard hemi (low seat) wheelchair |
37 |
37 |
$655.11 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
12 |
12 |
$632.18 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
12 |
12 |
$379.97 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
151 |
147 |
$314.93 |
| A4217 |
Sterile water/saline, 500 ml |
24 |
24 |
$181.21 |
| E0156 |
Seat attachment, walker |
168 |
161 |
$180.59 |
| A7525 |
Tracheostomy mask, each |
92 |
80 |
$71.54 |
| A7012 |
Water collection device, used with large volume nebulizer |
14 |
12 |
$30.71 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
32 |
28 |
$14.41 |
| A7015 |
Aerosol mask, used with dme nebulizer |
14 |
14 |
$8.81 |