| 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 |
11,614 |
9,109 |
$724K |
| E0601 |
Continuous positive airway pressure (cpap) device |
8,935 |
7,235 |
$364K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,840 |
1,309 |
$206K |
| 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 |
1,241 |
1,217 |
$183K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,442 |
1,789 |
$176K |
| K0001 |
Standard wheelchair |
6,554 |
5,205 |
$164K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
3,194 |
2,987 |
$147K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,679 |
7,974 |
$137K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,673 |
2,371 |
$128K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
2,728 |
2,671 |
$127K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
5,488 |
4,188 |
$121K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
603 |
589 |
$114K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
4,254 |
3,077 |
$108K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
1,330 |
1,287 |
$81K |
| K0003 |
Lightweight wheelchair |
1,951 |
1,496 |
$72K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,543 |
1,178 |
$70K |
| E0570 |
Nebulizer, with compressor |
4,432 |
3,223 |
$69K |
| 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 |
745 |
692 |
$68K |
| 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 |
262 |
258 |
$66K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
1,454 |
1,371 |
$63K |
| A7035 |
Headgear used with positive airway pressure device |
3,901 |
2,951 |
$57K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,749 |
2,129 |
$50K |
| 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) |
640 |
487 |
$50K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
5,412 |
4,022 |
$47K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,776 |
1,282 |
$47K |
| K0007 |
Extra heavy duty wheelchair |
558 |
441 |
$33K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,634 |
6,714 |
$27K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
893 |
653 |
$26K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
333 |
326 |
$26K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
118 |
111 |
$22K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,305 |
950 |
$21K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
394 |
302 |
$21K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,483 |
1,969 |
$19K |
| E1060 |
Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests |
284 |
212 |
$15K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
174 |
168 |
$15K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
767 |
456 |
$13K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
687 |
533 |
$12K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
364 |
260 |
$10K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
556 |
470 |
$9K |
| A4623 |
Tracheostomy, inner cannula |
146 |
102 |
$6K |
| A7000 |
Canister, disposable, used with suction pump, each |
713 |
513 |
$5K |
| A4565 |
Slings |
630 |
621 |
$5K |
| K0006 |
Heavy duty wheelchair |
59 |
52 |
$4K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,760 |
938 |
$4K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
70 |
43 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,261 |
986 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
354 |
236 |
$2K |
| A7002 |
Tubing, used with suction pump, each |
805 |
595 |
$2K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
16 |
16 |
$1K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
110 |
94 |
$1K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
19 |
12 |
$1K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
12 |
12 |
$1K |
| E1392 |
Portable oxygen concentrator, rental |
195 |
158 |
$1K |
| L3260 |
Surgical boot/shoe, each |
31 |
29 |
$954.80 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
77 |
62 |
$519.85 |
| A7015 |
Aerosol mask, used with dme nebulizer |
658 |
523 |
$510.82 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
18 |
13 |
$318.17 |
| E0156 |
Seat attachment, walker |
33 |
24 |
$106.66 |
| A4927 |
Gloves, non-sterile, per 100 |
26 |
12 |
$67.43 |