| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
7,888 |
7,861 |
$236K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,470 |
2,429 |
$179K |
| K0001 |
Standard wheelchair |
4,268 |
4,159 |
$123K |
| A4554 |
Disposable underpads, all sizes |
2,158 |
2,123 |
$70K |
| X1939 |
|
962 |
956 |
$57K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
899 |
891 |
$44K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
686 |
679 |
$39K |
| E0601 |
Continuous positive airway pressure (cpap) device |
709 |
700 |
$35K |
| T5999 |
Supply, not otherwise specified |
4,544 |
4,487 |
$34K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
429 |
425 |
$31K |
| E2386 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each |
185 |
184 |
$23K |
| K0006 |
Heavy duty wheelchair |
408 |
404 |
$23K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
750 |
746 |
$21K |
| E2387 |
Power wheelchair accessory, foam filled caster tire, any size, replacement only, each |
195 |
195 |
$21K |
| E2395 |
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
196 |
195 |
$16K |
| E2321 |
Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware |
15 |
15 |
$14K |
| E2366 |
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each |
157 |
157 |
$13K |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
184 |
184 |
$12K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
153 |
153 |
$11K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
980 |
961 |
$9K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
59 |
59 |
$5K |
| E0570 |
Nebulizer, with compressor |
350 |
347 |
$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 |
25 |
24 |
$4K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
24 |
24 |
$4K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
121 |
121 |
$4K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
121 |
121 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
174 |
173 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
109 |
109 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
14 |
14 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
53 |
53 |
$1K |
| K0019 |
Arm pad, replacement only, each |
52 |
52 |
$856.19 |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
12 |
12 |
$670.32 |
| A7031 |
Face mask interface, replacement for full face mask, each |
16 |
16 |
$667.72 |
| A7037 |
Tubing used with positive airway pressure device |
17 |
17 |
$373.34 |
| A4927 |
Gloves, non-sterile, per 100 |
38 |
25 |
$349.73 |
| A7035 |
Headgear used with positive airway pressure device |
17 |
17 |
$347.88 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
63 |
59 |
$247.17 |