| 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 |
7,897 |
6,852 |
$691K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,313 |
2,068 |
$242K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,034 |
2,703 |
$224K |
| E0570 |
Nebulizer, with compressor |
3,658 |
3,401 |
$201K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,847 |
2,564 |
$195K |
| 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 |
4,031 |
3,536 |
$93K |
| 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 |
607 |
592 |
$66K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,506 |
1,365 |
$59K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,310 |
2,892 |
$54K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,521 |
1,483 |
$54K |
| 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) |
339 |
308 |
$49K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
363 |
228 |
$48K |
| A7035 |
Headgear used with positive airway pressure device |
2,115 |
1,925 |
$48K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
225 |
218 |
$47K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
934 |
867 |
$41K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
832 |
763 |
$36K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,017 |
1,820 |
$36K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,291 |
1,256 |
$31K |
| K0001 |
Standard wheelchair |
1,125 |
993 |
$25K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
474 |
456 |
$25K |
| B9998 |
Noc for enteral supplies |
289 |
222 |
$21K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
149 |
146 |
$18K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
170 |
168 |
$16K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
345 |
306 |
$15K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,036 |
917 |
$12K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,371 |
1,224 |
$11K |
| A7037 |
Tubing used with positive airway pressure device |
2,892 |
2,531 |
$8K |
| A4565 |
Slings |
731 |
716 |
$4K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
26 |
25 |
$3K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
46 |
28 |
$3K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
55 |
36 |
$2K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
38 |
38 |
$2K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
28 |
28 |
$2K |
| L3260 |
Surgical boot/shoe, each |
107 |
95 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
822 |
436 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
303 |
292 |
$824.52 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
112 |
111 |
$496.46 |
| E1392 |
Portable oxygen concentrator, rental |
25 |
25 |
$25.53 |