| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
4,903 |
4,327 |
$531K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,110 |
3,634 |
$340K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,656 |
1,436 |
$81K |
| A7030 |
Full face mask used with positive airway pressure device, each |
683 |
564 |
$49K |
| A4554 |
Disposable underpads, all sizes |
1,882 |
1,651 |
$47K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,234 |
1,065 |
$39K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
317 |
282 |
$39K |
| E0570 |
Nebulizer, with compressor |
1,144 |
1,015 |
$28K |
| K0005 |
Ultralightweight wheelchair |
207 |
171 |
$26K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
275 |
213 |
$24K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
36 |
36 |
$22K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
687 |
571 |
$22K |
| K0001 |
Standard wheelchair |
1,423 |
1,182 |
$22K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
274 |
259 |
$21K |
| A7037 |
Tubing used with positive airway pressure device |
889 |
754 |
$19K |
| A7035 |
Headgear used with positive airway pressure device |
887 |
723 |
$17K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
96 |
80 |
$15K |
| E1392 |
Portable oxygen concentrator, rental |
1,057 |
933 |
$13K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
269 |
115 |
$12K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
297 |
242 |
$12K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
43 |
37 |
$11K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
310 |
254 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
913 |
759 |
$6K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
186 |
140 |
$6K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
159 |
129 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
485 |
390 |
$4K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
125 |
108 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
71 |
66 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
70 |
60 |
$1K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
21 |
13 |
$1K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
28 |
14 |
$802.10 |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
16 |
12 |
$739.58 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
38 |
29 |
$558.83 |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
28 |
24 |
$528.72 |
| A7031 |
Face mask interface, replacement for full face mask, each |
58 |
46 |
$432.72 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
77 |
66 |
$345.37 |