| 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 |
30,248 |
25,218 |
$1.23M |
| E0601 |
Continuous positive airway pressure (cpap) device |
12,904 |
11,033 |
$588K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,889 |
1,555 |
$504K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
17,440 |
15,075 |
$497K |
| K0001 |
Standard wheelchair |
32,090 |
27,497 |
$301K |
| A7030 |
Full face mask used with positive airway pressure device, each |
4,386 |
3,837 |
$270K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
7,826 |
6,707 |
$223K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,234 |
2,968 |
$170K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
3,023 |
2,642 |
$168K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
4,106 |
3,318 |
$164K |
| 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) |
1,343 |
1,183 |
$145K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
5,811 |
5,165 |
$144K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,760 |
1,549 |
$115K |
| E0570 |
Nebulizer, with compressor |
11,817 |
9,485 |
$109K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
10,971 |
9,016 |
$102K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
21,888 |
18,306 |
$94K |
| A7037 |
Tubing used with positive airway pressure device |
6,374 |
5,506 |
$93K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,986 |
1,664 |
$80K |
| A7035 |
Headgear used with positive airway pressure device |
5,116 |
4,414 |
$70K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
7,852 |
6,452 |
$65K |
| K0003 |
Lightweight wheelchair |
3,727 |
3,157 |
$55K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,335 |
2,025 |
$51K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
3,291 |
2,837 |
$50K |
| K0006 |
Heavy duty wheelchair |
3,002 |
2,518 |
$49K |
| K0007 |
Extra heavy duty wheelchair |
2,110 |
1,820 |
$48K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,825 |
7,673 |
$39K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
3,678 |
3,114 |
$34K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
2,007 |
1,801 |
$32K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
1,840 |
788 |
$31K |
| E1392 |
Portable oxygen concentrator, rental |
3,373 |
2,800 |
$26K |
| E0156 |
Seat attachment, walker |
3,877 |
3,341 |
$22K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
1,210 |
1,033 |
$21K |
| E0277 |
Powered pressure-reducing air mattress |
778 |
624 |
$20K |
| E2202 |
Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches |
1,161 |
987 |
$18K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
1,927 |
1,565 |
$18K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
6,743 |
3,491 |
$17K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
670 |
557 |
$16K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,738 |
2,470 |
$16K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
1,113 |
935 |
$15K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
1,930 |
1,576 |
$15K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,471 |
2,135 |
$14K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
862 |
379 |
$13K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
85 |
42 |
$11K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
734 |
577 |
$10K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
1,839 |
1,532 |
$8K |
| 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 |
113 |
108 |
$7K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
58 |
40 |
$7K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
2,573 |
2,168 |
$7K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
4,965 |
4,034 |
$6K |
| E0430 |
Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
200 |
173 |
$6K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,125 |
2,662 |
$5K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
171 |
116 |
$5K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
872 |
733 |
$2K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
459 |
386 |
$2K |
| K0002 |
Standard hemi (low seat) wheelchair |
99 |
77 |
$2K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
159 |
143 |
$2K |
| E0245 |
Tub stool or bench |
50 |
38 |
$1K |
| E0966 |
Manual wheelchair accessory, headrest extension, each |
676 |
517 |
$1K |
| A4259 |
Lancets, per box of 100 |
569 |
479 |
$1K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
42 |
37 |
$1K |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
122 |
95 |
$1K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
56 |
40 |
$975.69 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
27 |
25 |
$842.62 |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
40 |
39 |
$781.42 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
156 |
132 |
$662.83 |
| E1020 |
Residual limb support system for wheelchair, any type |
89 |
79 |
$629.87 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
33 |
12 |
$461.92 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
17 |
14 |
$391.42 |
| E0240 |
Bath/shower chair, with or without wheels, any size |
19 |
13 |
$284.85 |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
249 |
191 |
$231.54 |
| A4256 |
Normal, low and high calibrator solution / chips |
280 |
219 |
$225.91 |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
16 |
12 |
$201.20 |
| A4258 |
Spring-powered device for lancet, each |
295 |
234 |
$147.91 |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
140 |
52 |
$0.00 |