| 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 |
58,943 |
48,336 |
$3.16M |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
12,253 |
10,139 |
$1.77M |
| E0601 |
Continuous positive airway pressure (cpap) device |
36,765 |
31,610 |
$1.77M |
| A7030 |
Full face mask used with positive airway pressure device, each |
14,543 |
12,226 |
$1.02M |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
12,258 |
10,333 |
$650K |
| 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 |
5,558 |
4,628 |
$604K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
7,371 |
5,683 |
$535K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
11,214 |
8,862 |
$424K |
| A7037 |
Tubing used with positive airway pressure device |
22,086 |
18,967 |
$415K |
| 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 |
7,013 |
5,479 |
$408K |
| 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) |
4,143 |
3,403 |
$404K |
| E0570 |
Nebulizer, with compressor |
28,497 |
23,097 |
$357K |
| A7031 |
Face mask interface, replacement for full face mask, each |
11,636 |
9,602 |
$339K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
13,132 |
9,750 |
$324K |
| 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 |
2,462 |
2,102 |
$314K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
13,781 |
10,694 |
$299K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
905 |
797 |
$297K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
38,170 |
31,284 |
$273K |
| A7035 |
Headgear used with positive airway pressure device |
16,589 |
13,826 |
$267K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
4,761 |
4,064 |
$258K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
9,972 |
8,047 |
$258K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
6,977 |
5,771 |
$256K |
| K0001 |
Standard wheelchair |
18,146 |
14,669 |
$200K |
| K0003 |
Lightweight wheelchair |
9,956 |
8,086 |
$175K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
1,314 |
1,050 |
$158K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
31,337 |
24,249 |
$150K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
3,554 |
2,820 |
$148K |
| 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 |
1,682 |
1,445 |
$138K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
3,220 |
2,639 |
$125K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
5,558 |
4,355 |
$119K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
9,604 |
6,815 |
$102K |
| E1392 |
Portable oxygen concentrator, rental |
15,148 |
11,877 |
$83K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
9,820 |
8,318 |
$73K |
| L1832 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
867 |
616 |
$70K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
6,327 |
5,544 |
$70K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
276 |
216 |
$70K |
| L3650 |
Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
2,255 |
1,974 |
$67K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
7,373 |
4,611 |
$67K |
| K0007 |
Extra heavy duty wheelchair |
2,425 |
2,000 |
$65K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
2,568 |
2,047 |
$61K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
3,224 |
2,515 |
$58K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
9,301 |
8,003 |
$55K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
2,456 |
1,883 |
$51K |
| 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) |
266 |
237 |
$45K |
| L3984 |
Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment |
236 |
199 |
$37K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
791 |
685 |
$35K |
| A7036 |
Chinstrap used with positive airway pressure device |
3,900 |
3,266 |
$27K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
4,102 |
2,986 |
$22K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
313 |
271 |
$20K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
2,532 |
1,946 |
$16K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
5,813 |
4,667 |
$16K |
| E0156 |
Seat attachment, walker |
2,327 |
1,818 |
$13K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
270 |
243 |
$12K |
| L1843 |
Knee orthosis, single 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 item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
36 |
28 |
$11K |
| K0006 |
Heavy duty wheelchair |
616 |
469 |
$11K |
| L2795 |
Addition to lower extremity orthosis, knee control, full kneecap |
234 |
185 |
$10K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
1,116 |
855 |
$8K |
| E0168 |
Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each |
670 |
515 |
$7K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
99 |
97 |
$7K |
| E0720 |
Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation |
367 |
285 |
$6K |
| L3924 |
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
176 |
111 |
$6K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
41 |
36 |
$6K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
764 |
622 |
$5K |
| L3260 |
Surgical boot/shoe, each |
130 |
95 |
$5K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
1,171 |
957 |
$5K |
| E0430 |
Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
448 |
265 |
$3K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
834 |
666 |
$3K |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
42 |
36 |
$2K |
| A4467 |
Belt, strap, sleeve, garment, or covering, any type |
116 |
88 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,133 |
1,059 |
$2K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
221 |
172 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,071 |
2,827 |
$1K |
| K0004 |
High strength, lightweight wheelchair |
39 |
36 |
$1K |
| E0607 |
Home blood glucose monitor |
208 |
162 |
$831.26 |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
30 |
25 |
$716.47 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
116 |
91 |
$690.12 |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
59 |
49 |
$515.06 |
| A4259 |
Lancets, per box of 100 |
667 |
540 |
$227.47 |
| A4565 |
Slings |
46 |
29 |
$205.50 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
24 |
15 |
$78.46 |
| A4256 |
Normal, low and high calibrator solution / chips |
280 |
224 |
$74.29 |
| E0310 |
Bed side rails, full length |
111 |
87 |
$9.12 |