| 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 |
20,627 |
14,625 |
$822K |
| E0601 |
Continuous positive airway pressure (cpap) device |
11,703 |
9,166 |
$363K |
| E0570 |
Nebulizer, with compressor |
13,343 |
9,528 |
$198K |
| 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) |
2,292 |
1,719 |
$160K |
| L0627 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
389 |
321 |
$121K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,773 |
1,366 |
$110K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
5,919 |
4,778 |
$105K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,985 |
8,674 |
$99K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,539 |
1,977 |
$61K |
| E1093 |
Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests |
810 |
707 |
$54K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
1,546 |
729 |
$52K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,417 |
1,499 |
$50K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,040 |
643 |
$50K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,079 |
1,402 |
$48K |
| E1086 |
Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests |
768 |
629 |
$47K |
| E1392 |
Portable oxygen concentrator, rental |
2,949 |
2,181 |
$40K |
| E1140 |
Wheelchair, detachable arms, desk or full length, swing away detachable footrests |
1,500 |
1,299 |
$40K |
| L0642 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
169 |
127 |
$37K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,362 |
1,063 |
$36K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
3,041 |
2,337 |
$34K |
| A7035 |
Headgear used with positive airway pressure device |
2,322 |
1,779 |
$28K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
884 |
648 |
$26K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
657 |
507 |
$26K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
533 |
432 |
$16K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
26 |
12 |
$13K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
591 |
205 |
$12K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,780 |
2,927 |
$11K |
| E0184 |
Dry pressure mattress |
967 |
602 |
$11K |
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
125 |
53 |
$10K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,110 |
858 |
$9K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
133 |
75 |
$9K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
966 |
581 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
542 |
420 |
$6K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,406 |
1,085 |
$6K |
| E0202 |
Phototherapy (bilirubin) light with photometer |
44 |
14 |
$6K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
255 |
160 |
$6K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
47 |
39 |
$5K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
71 |
53 |
$4K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
19 |
12 |
$3K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
575 |
201 |
$3K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
139 |
113 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
3,140 |
2,448 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
433 |
160 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
107 |
65 |
$2K |
| 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 |
272 |
182 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,312 |
1,712 |
$1K |
| K0001 |
Standard wheelchair |
2,204 |
1,607 |
$1K |
| A4670 |
Automatic blood pressure monitor |
33 |
28 |
$1K |
| A4649 |
Surgical supply; miscellaneous |
214 |
123 |
$1K |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
14 |
12 |
$740.77 |
| A7002 |
Tubing, used with suction pump, each |
49 |
40 |
$721.01 |
| E0156 |
Seat attachment, walker |
135 |
85 |
$589.69 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
95 |
52 |
$482.23 |
| A7000 |
Canister, disposable, used with suction pump, each |
30 |
26 |
$417.80 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
19 |
13 |
$381.60 |
| E0245 |
Tub stool or bench |
14 |
12 |
$378.84 |
| E1084 |
Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests |
14 |
13 |
$277.56 |
| E0305 |
Bed side rails, half length |
55 |
36 |
$131.68 |
| K0002 |
Standard hemi (low seat) wheelchair |
762 |
578 |
$0.00 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
138 |
115 |
$0.00 |
| K0006 |
Heavy duty wheelchair |
32 |
25 |
$0.00 |
| K0052 |
Swingaway, detachable footrests, replacement only, each |
50 |
25 |
$0.00 |