| 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 |
10,612 |
7,941 |
$493K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,417 |
2,636 |
$112K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,270 |
1,039 |
$63K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,070 |
2,255 |
$61K |
| E0570 |
Nebulizer, with compressor |
4,249 |
3,167 |
$42K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,260 |
3,254 |
$35K |
| E1392 |
Portable oxygen concentrator, rental |
2,491 |
1,940 |
$33K |
| A4554 |
Disposable underpads, all sizes |
608 |
501 |
$31K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,534 |
1,113 |
$30K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
226 |
201 |
$27K |
| K0001 |
Standard wheelchair |
3,832 |
2,872 |
$25K |
| A7035 |
Headgear used with positive airway pressure device |
1,343 |
1,105 |
$16K |
| 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 |
726 |
557 |
$12K |
| A7037 |
Tubing used with positive airway pressure device |
808 |
631 |
$11K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
101 |
80 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,907 |
2,172 |
$7K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
638 |
570 |
$7K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
239 |
195 |
$6K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
202 |
176 |
$6K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
28 |
25 |
$5K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
31 |
29 |
$3K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
32 |
26 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
188 |
146 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
372 |
337 |
$2K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
168 |
136 |
$1K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
19 |
15 |
$1K |
| A4670 |
Automatic blood pressure monitor |
23 |
15 |
$929.07 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
37 |
25 |
$778.60 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
15 |
13 |
$458.22 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
77 |
64 |
$282.20 |