| 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 |
15,845 |
14,755 |
$508K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,261 |
1,166 |
$318K |
| E0601 |
Continuous positive airway pressure (cpap) device |
7,550 |
6,922 |
$187K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,647 |
10,898 |
$130K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,437 |
2,129 |
$111K |
| 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) |
1,324 |
1,171 |
$80K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,966 |
1,740 |
$72K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,352 |
2,122 |
$66K |
| K0001 |
Standard wheelchair |
2,298 |
2,134 |
$56K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,127 |
1,939 |
$45K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,787 |
2,596 |
$43K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,399 |
3,120 |
$38K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
450 |
421 |
$35K |
| A7035 |
Headgear used with positive airway pressure device |
3,491 |
3,209 |
$28K |
| 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) |
246 |
197 |
$28K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,875 |
1,689 |
$27K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,234 |
983 |
$26K |
| 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 |
244 |
231 |
$25K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
745 |
685 |
$24K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
947 |
870 |
$20K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
814 |
748 |
$18K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
603 |
545 |
$15K |
| K0003 |
Lightweight wheelchair |
351 |
329 |
$13K |
| E0570 |
Nebulizer, with compressor |
2,175 |
2,035 |
$13K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,554 |
4,985 |
$11K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
867 |
799 |
$10K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
675 |
640 |
$9K |
| A7037 |
Tubing used with positive airway pressure device |
1,509 |
1,392 |
$8K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
387 |
351 |
$8K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
92 |
90 |
$8K |
| E0245 |
Tub stool or bench |
364 |
331 |
$8K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,241 |
565 |
$6K |
| E1392 |
Portable oxygen concentrator, rental |
516 |
484 |
$5K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,739 |
798 |
$5K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,415 |
1,310 |
$5K |
| L3924 |
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
130 |
102 |
$4K |
| L1852 |
Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf |
14 |
12 |
$4K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
306 |
281 |
$4K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
12 |
12 |
$3K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
196 |
184 |
$3K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
1,908 |
887 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
792 |
732 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,422 |
1,347 |
$2K |
| A4670 |
Automatic blood pressure monitor |
44 |
44 |
$1K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
50 |
46 |
$817.58 |
| 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 |
13 |
12 |
$640.08 |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
13 |
12 |
$505.07 |
| E0156 |
Seat attachment, walker |
89 |
80 |
$460.43 |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
12 |
12 |
$438.21 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
256 |
126 |
$433.16 |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
15 |
13 |
$393.49 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
14 |
12 |
$258.30 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
14 |
13 |
$112.28 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
30 |
28 |
$14.26 |