| 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 |
11,372 |
10,823 |
$725K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,380 |
5,205 |
$272K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,411 |
3,274 |
$243K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
625 |
616 |
$127K |
| E0570 |
Nebulizer, with compressor |
9,671 |
9,227 |
$99K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
6,536 |
6,305 |
$93K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,326 |
2,268 |
$88K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,651 |
7,320 |
$79K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,551 |
1,440 |
$68K |
| 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) |
685 |
654 |
$67K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,535 |
2,424 |
$61K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
2,472 |
1,694 |
$57K |
| A7035 |
Headgear used with positive airway pressure device |
3,649 |
3,489 |
$49K |
| K0001 |
Standard wheelchair |
2,331 |
2,238 |
$45K |
| A7037 |
Tubing used with positive airway pressure device |
3,509 |
3,337 |
$43K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,369 |
1,291 |
$35K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
247 |
224 |
$24K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
185 |
182 |
$23K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,272 |
2,168 |
$17K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
394 |
359 |
$17K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,197 |
3,991 |
$16K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,564 |
2,424 |
$14K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
482 |
470 |
$12K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
416 |
404 |
$9K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
13 |
13 |
$9K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
559 |
516 |
$9K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,451 |
1,372 |
$7K |
| T4541 |
Incontinence product, disposable underpad, large, each |
292 |
262 |
$6K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,086 |
1,008 |
$6K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
564 |
429 |
$6K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
203 |
136 |
$6K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,082 |
1,012 |
$2K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
210 |
198 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
15 |
12 |
$1K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13 |
12 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
216 |
216 |
$835.80 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
26 |
26 |
$547.49 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
58 |
50 |
$497.03 |
| E0277 |
Powered pressure-reducing air mattress |
12 |
12 |
$490.38 |