| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
1,898 |
1,889 |
$186K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,332 |
1,330 |
$177K |
| K0001 |
Standard wheelchair |
7,894 |
7,705 |
$113K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,089 |
2,907 |
$98K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
594 |
593 |
$67K |
| K0003 |
Lightweight wheelchair |
3,639 |
3,621 |
$65K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,714 |
2,653 |
$59K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,487 |
1,456 |
$53K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
656 |
655 |
$53K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
504 |
501 |
$49K |
| K0002 |
Standard hemi (low seat) wheelchair |
1,827 |
1,823 |
$44K |
| K0007 |
Extra heavy duty wheelchair |
1,059 |
1,058 |
$41K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
586 |
566 |
$31K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
212 |
209 |
$21K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
1,264 |
1,235 |
$20K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
892 |
859 |
$19K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
4,222 |
4,180 |
$18K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,048 |
2,857 |
$16K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,393 |
1,366 |
$13K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
236 |
229 |
$13K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
1,373 |
1,348 |
$12K |
| E0245 |
Tub stool or bench |
213 |
213 |
$12K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,314 |
1,291 |
$10K |
| E0373 |
Nonpowered advanced pressure reducing mattress |
91 |
85 |
$4K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
77 |
74 |
$3K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
684 |
661 |
$3K |
| E0570 |
Nebulizer, with compressor |
631 |
623 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
114 |
114 |
$2K |
| E0156 |
Seat attachment, walker |
257 |
246 |
$1K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
14 |
13 |
$218.62 |