| 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 |
26,703 |
24,950 |
$1.91M |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
2,208 |
2,077 |
$368K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,192 |
5,727 |
$347K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
6,481 |
6,009 |
$286K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,734 |
1,624 |
$278K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
710 |
659 |
$250K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,688 |
2,561 |
$247K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,483 |
2,367 |
$226K |
| 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 |
11,397 |
10,723 |
$204K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
576 |
557 |
$198K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
955 |
893 |
$143K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,024 |
2,824 |
$143K |
| E0570 |
Nebulizer, with compressor |
9,854 |
9,137 |
$143K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,380 |
4,141 |
$142K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,146 |
2,016 |
$117K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,176 |
1,106 |
$114K |
| 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) |
1,045 |
1,012 |
$105K |
| K0001 |
Standard wheelchair |
4,683 |
4,324 |
$96K |
| K0002 |
Standard hemi (low seat) wheelchair |
2,501 |
2,373 |
$65K |
| E1392 |
Portable oxygen concentrator, rental |
5,613 |
5,389 |
$57K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,518 |
4,285 |
$55K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,828 |
1,720 |
$52K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,577 |
1,462 |
$51K |
| A7035 |
Headgear used with positive airway pressure device |
2,994 |
2,837 |
$50K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,354 |
1,135 |
$50K |
| K0006 |
Heavy duty wheelchair |
1,249 |
1,154 |
$49K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,681 |
2,519 |
$39K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
486 |
464 |
$38K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
8,418 |
7,872 |
$37K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
481 |
406 |
$37K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
445 |
426 |
$29K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
2,597 |
2,311 |
$27K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
532 |
479 |
$26K |
| K0003 |
Lightweight wheelchair |
812 |
731 |
$25K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,410 |
1,317 |
$18K |
| 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 |
299 |
245 |
$18K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,853 |
1,770 |
$17K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
972 |
920 |
$16K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
408 |
370 |
$14K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
104 |
92 |
$12K |
| A4670 |
Automatic blood pressure monitor |
87 |
78 |
$11K |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
201 |
182 |
$11K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
525 |
474 |
$9K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
551 |
456 |
$7K |
| K0007 |
Extra heavy duty wheelchair |
102 |
99 |
$6K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,047 |
669 |
$6K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
642 |
580 |
$5K |
| A7036 |
Chinstrap used with positive airway pressure device |
523 |
498 |
$5K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
97 |
89 |
$5K |
| E0156 |
Seat attachment, walker |
509 |
472 |
$4K |
| E2202 |
Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches |
192 |
179 |
$4K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
28 |
26 |
$3K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
468 |
412 |
$3K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
398 |
387 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
155 |
138 |
$2K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
234 |
221 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
106 |
102 |
$2K |
| L3924 |
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
31 |
29 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
62 |
62 |
$1K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
154 |
97 |
$1K |
| L4398 |
Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf |
41 |
39 |
$1K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
40 |
39 |
$1K |
| T4541 |
Incontinence product, disposable underpad, large, each |
19 |
15 |
$1K |
| A4565 |
Slings |
133 |
127 |
$784.39 |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
14 |
12 |
$773.73 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
117 |
94 |
$524.57 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
258 |
236 |
$387.20 |
| A4927 |
Gloves, non-sterile, per 100 |
15 |
12 |
$352.20 |
| K0004 |
High strength, lightweight wheelchair |
18 |
12 |
$305.60 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
12 |
12 |
$65.48 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
31 |
24 |
$26.29 |