| 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 |
14,534 |
13,500 |
$774K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,065 |
2,905 |
$229K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
1,224 |
1,142 |
$167K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,229 |
3,923 |
$156K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,733 |
4,500 |
$156K |
| 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) |
1,758 |
1,656 |
$134K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,730 |
1,654 |
$97K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,601 |
6,899 |
$86K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,573 |
1,342 |
$70K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,120 |
2,016 |
$61K |
| 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 |
386 |
360 |
$48K |
| A7035 |
Headgear used with positive airway pressure device |
2,950 |
2,800 |
$48K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,539 |
1,463 |
$41K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
302 |
288 |
$38K |
| E1392 |
Portable oxygen concentrator, rental |
1,700 |
1,578 |
$34K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
171 |
152 |
$30K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,125 |
6,751 |
$28K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
717 |
540 |
$27K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
563 |
534 |
$26K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
141 |
136 |
$24K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,215 |
2,096 |
$23K |
| E0570 |
Nebulizer, with compressor |
3,359 |
3,229 |
$22K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
97 |
85 |
$7K |
| 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 |
277 |
264 |
$6K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
265 |
245 |
$6K |
| A4565 |
Slings |
756 |
731 |
$6K |
| K0003 |
Lightweight wheelchair |
291 |
242 |
$6K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
285 |
195 |
$5K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
192 |
52 |
$5K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
116 |
100 |
$4K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
40 |
37 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
66 |
63 |
$2K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
189 |
179 |
$2K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
53 |
49 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
86 |
83 |
$1K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
12 |
12 |
$298.05 |
| A7015 |
Aerosol mask, used with dme nebulizer |
104 |
102 |
$109.86 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
45 |
43 |
$87.38 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
13 |
12 |
$67.56 |