| 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 |
31,639 |
29,480 |
$1.61M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
25,451 |
24,003 |
$240K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,762 |
2,588 |
$197K |
| K0001 |
Standard wheelchair |
13,644 |
12,932 |
$170K |
| 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) |
1,081 |
978 |
$124K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,762 |
1,604 |
$103K |
| E0570 |
Nebulizer, with compressor |
4,072 |
3,788 |
$88K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,839 |
2,597 |
$84K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
3,075 |
2,951 |
$68K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,295 |
2,087 |
$52K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
338 |
336 |
$47K |
| E0147 |
Walker, heavy duty, multiple braking system, variable wheel resistance |
226 |
211 |
$42K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,716 |
1,527 |
$36K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
288 |
267 |
$31K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
4,218 |
3,800 |
$31K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
283 |
279 |
$30K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
206 |
202 |
$22K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
88 |
86 |
$22K |
| A7035 |
Headgear used with positive airway pressure device |
1,889 |
1,707 |
$22K |
| K0003 |
Lightweight wheelchair |
1,534 |
1,365 |
$22K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
907 |
857 |
$18K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
462 |
411 |
$16K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
340 |
339 |
$14K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,102 |
4,606 |
$14K |
| A4554 |
Disposable underpads, all sizes |
325 |
310 |
$11K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
232 |
227 |
$11K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
878 |
811 |
$11K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
445 |
438 |
$9K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
365 |
335 |
$8K |
| K0006 |
Heavy duty wheelchair |
393 |
357 |
$8K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
431 |
396 |
$5K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
26 |
26 |
$4K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
87 |
78 |
$3K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
30 |
26 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
313 |
284 |
$1K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12 |
12 |
$1K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
15 |
12 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
169 |
157 |
$1K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
16 |
14 |
$1K |
| K0007 |
Extra heavy duty wheelchair |
12 |
12 |
$888.35 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
158 |
76 |
$810.22 |
| E0184 |
Dry pressure mattress |
29 |
28 |
$809.75 |
| K0800 |
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds |
13 |
13 |
$515.17 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
30 |
27 |
$391.92 |
| K0002 |
Standard hemi (low seat) wheelchair |
29 |
26 |
$321.71 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
12 |
12 |
$275.11 |
| A7037 |
Tubing used with positive airway pressure device |
35 |
33 |
$231.42 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
36 |
36 |
$111.68 |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
85 |
83 |
$69.16 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
25 |
25 |
$43.44 |