| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
1,787 |
1,756 |
$118K |
| K0001 |
Standard wheelchair |
3,730 |
3,707 |
$70K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,999 |
1,963 |
$44K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,239 |
1,238 |
$40K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
982 |
981 |
$31K |
| E0570 |
Nebulizer, with compressor |
516 |
514 |
$20K |
| 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 |
915 |
467 |
$19K |
| L0642 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
52 |
52 |
$13K |
| T4541 |
Incontinence product, disposable underpad, large, each |
250 |
246 |
$13K |
| E0305 |
Bed side rails, half length |
1,092 |
1,087 |
$9K |
| E0156 |
Seat attachment, walker |
1,107 |
1,106 |
$9K |
| 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 |
796 |
455 |
$8K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
106 |
106 |
$7K |
| E0272 |
Mattress, foam rubber |
749 |
748 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
245 |
244 |
$1K |
| K0003 |
Lightweight wheelchair |
49 |
49 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
198 |
194 |
$959.43 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
32 |
32 |
$754.79 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
61 |
61 |
$730.67 |
| E0245 |
Tub stool or bench |
12 |
12 |
$698.24 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
50 |
50 |
$594.81 |
| A7037 |
Tubing used with positive airway pressure device |
24 |
24 |
$492.11 |
| A7031 |
Face mask interface, replacement for full face mask, each |
12 |
12 |
$479.78 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
14 |
14 |
$301.28 |
| A7035 |
Headgear used with positive airway pressure device |
12 |
12 |
$273.16 |
| A7015 |
Aerosol mask, used with dme nebulizer |
29 |
29 |
$54.72 |