| 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 |
3,169 |
2,889 |
$332K |
| K0001 |
Standard wheelchair |
11,814 |
11,082 |
$214K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,804 |
3,531 |
$177K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,525 |
1,434 |
$158K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,778 |
1,641 |
$57K |
| K0003 |
Lightweight wheelchair |
1,563 |
1,473 |
$53K |
| E0245 |
Tub stool or bench |
869 |
752 |
$53K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
4,513 |
4,218 |
$50K |
| E0570 |
Nebulizer, with compressor |
2,828 |
2,609 |
$41K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,016 |
2,699 |
$28K |
| K0007 |
Extra heavy duty wheelchair |
571 |
544 |
$24K |
| K0006 |
Heavy duty wheelchair |
614 |
573 |
$23K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
833 |
771 |
$19K |
| A7526 |
Tracheostomy tube collar/holder, each |
272 |
254 |
$15K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
520 |
469 |
$14K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
266 |
201 |
$11K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
580 |
547 |
$10K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
78 |
70 |
$6K |
| E0156 |
Seat attachment, walker |
641 |
595 |
$5K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,015 |
938 |
$5K |
| A4623 |
Tracheostomy, inner cannula |
40 |
38 |
$5K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
2,406 |
2,261 |
$3K |
| A7000 |
Canister, disposable, used with suction pump, each |
326 |
302 |
$2K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
66 |
64 |
$2K |
| A7002 |
Tubing, used with suction pump, each |
381 |
363 |
$2K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
595 |
554 |
$2K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
13 |
12 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
209 |
196 |
$947.34 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
96 |
87 |
$727.32 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
330 |
293 |
$548.15 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
44 |
41 |
$429.13 |
| E0433 |
Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge |
12 |
12 |
$332.20 |
| A7015 |
Aerosol mask, used with dme nebulizer |
280 |
254 |
$242.92 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
125 |
121 |
$196.13 |