| 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 |
15,108 |
14,151 |
$923K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,764 |
11,143 |
$326K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,301 |
4,032 |
$240K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,121 |
1,096 |
$198K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
1,753 |
1,674 |
$96K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,469 |
1,358 |
$90K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
2,255 |
2,116 |
$88K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
3,742 |
3,618 |
$81K |
| 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) |
741 |
672 |
$72K |
| A7030 |
Full face mask used with positive airway pressure device, each |
959 |
897 |
$69K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,890 |
1,679 |
$60K |
| K0001 |
Standard wheelchair |
1,982 |
1,838 |
$46K |
| E0570 |
Nebulizer, with compressor |
1,537 |
1,467 |
$42K |
| A7035 |
Headgear used with positive airway pressure device |
1,596 |
1,490 |
$37K |
| A7037 |
Tubing used with positive airway pressure device |
1,278 |
1,197 |
$25K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
643 |
610 |
$23K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
258 |
249 |
$15K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
338 |
308 |
$7K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
149 |
143 |
$7K |
| K0007 |
Extra heavy duty wheelchair |
80 |
78 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,010 |
1,729 |
$4K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
634 |
390 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
84 |
78 |
$3K |
| A7031 |
Face mask interface, replacement for full face mask, each |
118 |
113 |
$3K |
| E0604 |
Breast pump, hospital grade, electric (ac and / or dc), any type |
56 |
50 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
55 |
51 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
276 |
248 |
$627.71 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
63 |
63 |
$374.20 |
| E1392 |
Portable oxygen concentrator, rental |
26 |
25 |
$324.83 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
96 |
51 |
$309.79 |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
27 |
26 |
$298.61 |
| L3260 |
Surgical boot/shoe, each |
187 |
163 |
$124.20 |