| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,475 |
3,359 |
$174K |
| K0001 |
Standard wheelchair |
8,704 |
8,254 |
$118K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
124 |
123 |
$99K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
2,582 |
2,507 |
$71K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,069 |
1,024 |
$49K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,041 |
943 |
$49K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
454 |
428 |
$46K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
3,175 |
3,151 |
$38K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
317 |
272 |
$36K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,126 |
1,089 |
$32K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
1,039 |
977 |
$26K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
252 |
241 |
$26K |
| T4541 |
Incontinence product, disposable underpad, large, each |
391 |
364 |
$19K |
| K0816 |
Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds |
191 |
183 |
$15K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
6,001 |
5,939 |
$12K |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
223 |
221 |
$11K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
290 |
277 |
$9K |
| E0601 |
Continuous positive airway pressure (cpap) device |
162 |
159 |
$8K |
| K0006 |
Heavy duty wheelchair |
222 |
208 |
$7K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
52 |
51 |
$6K |
| K0003 |
Lightweight wheelchair |
421 |
407 |
$6K |
| E0570 |
Nebulizer, with compressor |
355 |
335 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
212 |
207 |
$4K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
42 |
39 |
$4K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
28 |
25 |
$4K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
224 |
220 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
303 |
285 |
$3K |
| E0156 |
Seat attachment, walker |
468 |
464 |
$3K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
234 |
234 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
34 |
26 |
$3K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
98 |
93 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
74 |
63 |
$1K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
39 |
30 |
$1K |
| 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 |
76 |
55 |
$892.36 |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
93 |
71 |
$845.77 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
186 |
182 |
$443.23 |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
13 |
13 |
$436.73 |
| E0244 |
Raised toilet seat |
14 |
13 |
$351.52 |
| K0002 |
Standard hemi (low seat) wheelchair |
25 |
25 |
$264.58 |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
31 |
31 |
$5.91 |
| A7015 |
Aerosol mask, used with dme nebulizer |
53 |
39 |
$5.12 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
50 |
36 |
$4.50 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
53 |
39 |
$4.46 |