| 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 |
4,385 |
2,751 |
$69K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
931 |
492 |
$45K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
2,110 |
977 |
$31K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
242 |
142 |
$17K |
| E0570 |
Nebulizer, with compressor |
1,671 |
1,067 |
$16K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
904 |
422 |
$16K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,259 |
697 |
$16K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
556 |
269 |
$14K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
397 |
224 |
$10K |
| K0003 |
Lightweight wheelchair |
1,394 |
1,006 |
$9K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,515 |
1,622 |
$7K |
| L3807 |
Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
78 |
42 |
$6K |
| L3808 |
Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment |
31 |
25 |
$5K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
325 |
180 |
$4K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
57 |
27 |
$4K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
93 |
60 |
$2K |
| L3650 |
Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
198 |
74 |
$2K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
49 |
26 |
$2K |
| E1140 |
Wheelchair, detachable arms, desk or full length, swing away detachable footrests |
99 |
84 |
$1K |
| 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 |
46 |
12 |
$853.19 |
| E0430 |
Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
139 |
107 |
$806.44 |
| E0156 |
Seat attachment, walker |
137 |
80 |
$449.02 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
26 |
12 |
$350.84 |
| A4927 |
Gloves, non-sterile, per 100 |
121 |
67 |
$312.01 |
| L3806 |
Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment |
93 |
56 |
$188.00 |
| L3260 |
Surgical boot/shoe, each |
35 |
12 |
$67.29 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
17 |
14 |
$0.00 |