| 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 |
15,082 |
14,603 |
$759K |
| E0601 |
Continuous positive airway pressure (cpap) device |
9,143 |
8,838 |
$449K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,955 |
3,810 |
$238K |
| 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) |
2,012 |
1,956 |
$218K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,102 |
2,031 |
$188K |
| L4360 |
Walking boot, pneumatic and/or vacuum, 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 |
1,050 |
1,019 |
$158K |
| E0570 |
Nebulizer, with compressor |
5,487 |
5,337 |
$144K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
2,829 |
2,739 |
$143K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
3,672 |
3,196 |
$122K |
| 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 |
5,927 |
5,720 |
$122K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
4,871 |
4,720 |
$97K |
| 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 |
725 |
684 |
$93K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
808 |
762 |
$90K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,618 |
3,489 |
$84K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
1,692 |
1,635 |
$72K |
| A7035 |
Headgear used with positive airway pressure device |
3,606 |
3,482 |
$66K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,829 |
1,752 |
$65K |
| K0001 |
Standard wheelchair |
1,946 |
1,888 |
$48K |
| E1392 |
Portable oxygen concentrator, rental |
2,952 |
2,846 |
$45K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,225 |
1,181 |
$41K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
240 |
225 |
$40K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,364 |
1,305 |
$39K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,059 |
1,998 |
$29K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,359 |
1,320 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,155 |
5,825 |
$16K |
| A7037 |
Tubing used with positive airway pressure device |
811 |
787 |
$14K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
561 |
549 |
$12K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
258 |
230 |
$10K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
724 |
698 |
$6K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
217 |
208 |
$4K |
| K0003 |
Lightweight wheelchair |
113 |
111 |
$3K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
32 |
32 |
$929.88 |
| L2795 |
Addition to lower extremity orthosis, knee control, full kneecap |
15 |
13 |
$712.22 |
| L3924 |
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
13 |
12 |
$707.40 |