| 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 |
62,631 |
46,309 |
$2.48M |
| E0601 |
Continuous positive airway pressure (cpap) device |
35,237 |
29,717 |
$1.11M |
| A7030 |
Full face mask used with positive airway pressure device, each |
13,308 |
10,422 |
$778K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
4,403 |
3,615 |
$624K |
| E0570 |
Nebulizer, with compressor |
60,676 |
51,100 |
$578K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
20,812 |
16,749 |
$523K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
35,616 |
31,021 |
$442K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,432 |
1,031 |
$399K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
10,132 |
8,244 |
$389K |
| 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) |
6,093 |
4,838 |
$368K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
38,356 |
27,107 |
$279K |
| A4670 |
Automatic blood pressure monitor |
5,628 |
5,158 |
$219K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
1,657 |
1,348 |
$206K |
| E1392 |
Portable oxygen concentrator, rental |
15,571 |
11,671 |
$205K |
| A7035 |
Headgear used with positive airway pressure device |
15,726 |
12,587 |
$195K |
| A7031 |
Face mask interface, replacement for full face mask, each |
13,643 |
9,917 |
$191K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
5,538 |
4,021 |
$188K |
| E1140 |
Wheelchair, detachable arms, desk or full length, swing away detachable footrests |
8,894 |
7,578 |
$186K |
| 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 |
1,997 |
1,515 |
$141K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
5,824 |
4,504 |
$137K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
8,334 |
6,000 |
$135K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
2,436 |
1,937 |
$110K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
40,214 |
31,704 |
$105K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
9,917 |
8,245 |
$103K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
5,311 |
4,040 |
$92K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
568 |
473 |
$72K |
| E0202 |
Phototherapy (bilirubin) light with photometer |
392 |
232 |
$67K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
4,888 |
3,758 |
$62K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
8,632 |
6,914 |
$61K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,311 |
3,179 |
$58K |
| E1290 |
Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest |
1,105 |
945 |
$38K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
9,011 |
7,264 |
$37K |
| E0245 |
Tub stool or bench |
1,526 |
1,012 |
$24K |
| A7037 |
Tubing used with positive airway pressure device |
2,323 |
1,808 |
$24K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
325 |
269 |
$23K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
369 |
231 |
$22K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
264 |
188 |
$20K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
517 |
249 |
$20K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,888 |
1,282 |
$18K |
| E0156 |
Seat attachment, walker |
2,911 |
2,190 |
$18K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
56 |
42 |
$18K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
754 |
564 |
$15K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
133 |
110 |
$14K |
| A7036 |
Chinstrap used with positive airway pressure device |
1,831 |
1,500 |
$14K |
| E1260 |
Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest |
364 |
308 |
$14K |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
228 |
198 |
$12K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
1,077 |
698 |
$11K |
| A7015 |
Aerosol mask, used with dme nebulizer |
11,273 |
9,425 |
$9K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
234 |
191 |
$8K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
106 |
76 |
$8K |
| L3924 |
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
175 |
104 |
$7K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
94 |
52 |
$7K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
548 |
261 |
$6K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
364 |
241 |
$6K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
698 |
476 |
$5K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
160 |
81 |
$4K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
162 |
155 |
$4K |
| E0271 |
Mattress, innerspring |
4,170 |
2,744 |
$4K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
40 |
28 |
$4K |
| J9190 |
Injection, fluorouracil, 500 mg |
336 |
183 |
$4K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
122 |
93 |
$3K |
| A6550 |
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories |
28 |
15 |
$3K |
| A7000 |
Canister, disposable, used with suction pump, each |
141 |
79 |
$3K |
| K0001 |
Standard wheelchair |
5,736 |
4,583 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
8,841 |
7,437 |
$2K |
| E0110 |
Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips |
32 |
31 |
$2K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
389 |
297 |
$2K |
| E0305 |
Bed side rails, half length |
3,274 |
2,186 |
$1K |
| K0045 |
Footrest, complete assembly, replacement only, each |
6,679 |
4,341 |
$1K |
| E0310 |
Bed side rails, full length |
1,897 |
1,182 |
$1K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
86 |
63 |
$1K |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
747 |
634 |
$1K |
| E0244 |
Raised toilet seat |
42 |
25 |
$1K |
| E0148 |
Walker, heavy duty, without wheels, rigid or folding, any type, each |
30 |
24 |
$862.44 |
| E0621 |
Sling or seat, patient lift, canvas or nylon |
1,392 |
811 |
$814.42 |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
12 |
12 |
$715.41 |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
113 |
94 |
$295.02 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
684 |
564 |
$238.42 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
477 |
359 |
$54.19 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
14 |
12 |
$29.73 |
| E1093 |
Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests |
27 |
25 |
$26.10 |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
76 |
62 |
$0.00 |
| K0007 |
Extra heavy duty wheelchair |
538 |
375 |
$0.00 |
| K0003 |
Lightweight wheelchair |
30 |
28 |
$0.00 |