| 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 |
7,869 |
7,735 |
$498K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,434 |
3,226 |
$117K |
| K0001 |
Standard wheelchair |
5,179 |
4,938 |
$77K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,068 |
5,983 |
$74K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,623 |
1,589 |
$63K |
| E0570 |
Nebulizer, with compressor |
2,864 |
2,809 |
$44K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,304 |
1,279 |
$25K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
738 |
715 |
$19K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
314 |
295 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
480 |
471 |
$7K |
| A7035 |
Headgear used with positive airway pressure device |
504 |
497 |
$7K |
| A7030 |
Full face mask used with positive airway pressure device, each |
90 |
90 |
$7K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
155 |
146 |
$6K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
181 |
155 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
632 |
548 |
$5K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
104 |
99 |
$4K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
169 |
169 |
$2K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
59 |
54 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
302 |
297 |
$1K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
113 |
103 |
$1K |
| K0007 |
Extra heavy duty wheelchair |
14 |
12 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
75 |
70 |
$976.34 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
43 |
38 |
$761.39 |
| K0006 |
Heavy duty wheelchair |
24 |
24 |
$658.40 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
26 |
26 |
$458.67 |
| A7031 |
Face mask interface, replacement for full face mask, each |
12 |
12 |
$249.57 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
30 |
30 |
$154.53 |
| A7015 |
Aerosol mask, used with dme nebulizer |
64 |
57 |
$64.81 |