| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
4,615 |
4,475 |
$1.31M |
| A4554 |
Disposable underpads, all sizes |
3,521 |
3,454 |
$730K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,749 |
1,722 |
$87K |
| A7030 |
Full face mask used with positive airway pressure device, each |
542 |
536 |
$71K |
| K0001 |
Standard wheelchair |
2,328 |
2,301 |
$57K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
789 |
786 |
$42K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,274 |
1,170 |
$41K |
| E0601 |
Continuous positive airway pressure (cpap) device |
375 |
354 |
$39K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
763 |
752 |
$37K |
| A4927 |
Gloves, non-sterile, per 100 |
2,860 |
2,784 |
$37K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
681 |
650 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,379 |
2,362 |
$15K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
331 |
322 |
$14K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
113 |
111 |
$12K |
| A7035 |
Headgear used with positive airway pressure device |
381 |
379 |
$11K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
238 |
224 |
$10K |
| K0003 |
Lightweight wheelchair |
498 |
456 |
$8K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
878 |
852 |
$8K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
89 |
77 |
$7K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
206 |
205 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
228 |
224 |
$2K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
176 |
168 |
$2K |
| E0156 |
Seat attachment, walker |
149 |
135 |
$2K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
16 |
12 |
$1K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
14 |
12 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
12 |
12 |
$912.42 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
38 |
37 |
$543.62 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
12 |
12 |
$511.83 |