| 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 |
18,621 |
18,542 |
$1.40M |
| E0601 |
Continuous positive airway pressure (cpap) device |
17,616 |
17,580 |
$875K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
8,437 |
8,392 |
$306K |
| K0001 |
Standard wheelchair |
16,557 |
16,451 |
$300K |
| E0570 |
Nebulizer, with compressor |
6,116 |
6,093 |
$262K |
| 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) |
2,449 |
2,442 |
$259K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
14,706 |
14,659 |
$221K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
18,836 |
18,788 |
$189K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,021 |
2,000 |
$102K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,557 |
2,532 |
$96K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
2,695 |
2,680 |
$73K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
523 |
493 |
$57K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,838 |
1,831 |
$53K |
| K0006 |
Heavy duty wheelchair |
1,528 |
1,516 |
$44K |
| A7035 |
Headgear used with positive airway pressure device |
2,993 |
2,972 |
$40K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,661 |
2,646 |
$39K |
| K0007 |
Extra heavy duty wheelchair |
832 |
829 |
$35K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
7,064 |
6,981 |
$34K |
| A7037 |
Tubing used with positive airway pressure device |
2,084 |
2,078 |
$34K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,073 |
1,060 |
$29K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,133 |
1,120 |
$28K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
1,309 |
1,271 |
$28K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,541 |
4,503 |
$22K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
178 |
168 |
$17K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,912 |
1,711 |
$13K |
| K0003 |
Lightweight wheelchair |
581 |
575 |
$13K |
| B9002 |
Enteral nutrition infusion pump, any type |
369 |
365 |
$12K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,388 |
1,382 |
$11K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,157 |
2,143 |
$10K |
| E0156 |
Seat attachment, walker |
1,307 |
1,301 |
$10K |
| E1392 |
Portable oxygen concentrator, rental |
823 |
822 |
$8K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
346 |
341 |
$8K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
36 |
36 |
$7K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
162 |
160 |
$7K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
757 |
751 |
$5K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
379 |
378 |
$5K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
2,799 |
1,632 |
$5K |
| 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 |
48 |
48 |
$3K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
140 |
138 |
$3K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
126 |
124 |
$3K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
137 |
129 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
173 |
171 |
$2K |
| E0776 |
Iv pole |
353 |
350 |
$2K |
| E0561 |
Humidifier, non-heated, used with positive airway pressure device |
159 |
159 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
206 |
193 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
935 |
929 |
$1K |
| K0002 |
Standard hemi (low seat) wheelchair |
54 |
54 |
$791.31 |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
24 |
24 |
$496.81 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
53 |
53 |
$285.06 |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
12 |
12 |
$236.24 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
26 |
26 |
$221.95 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
134 |
133 |
$186.28 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
15 |
12 |
$94.56 |
| A7036 |
Chinstrap used with positive airway pressure device |
13 |
13 |
$35.57 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
129 |
125 |
$10.75 |