| 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 |
7,685 |
7,607 |
$681K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,946 |
5,891 |
$102K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,542 |
1,533 |
$86K |
| E0570 |
Nebulizer, with compressor |
1,248 |
1,238 |
$60K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,356 |
1,331 |
$56K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
638 |
624 |
$33K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
168 |
168 |
$28K |
| K0001 |
Standard wheelchair |
1,405 |
1,385 |
$22K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
734 |
730 |
$21K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,573 |
1,566 |
$20K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
150 |
148 |
$20K |
| A7030 |
Full face mask used with positive airway pressure device, each |
236 |
230 |
$17K |
| 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) |
136 |
136 |
$13K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
587 |
570 |
$13K |
| A7035 |
Headgear used with positive airway pressure device |
506 |
491 |
$10K |
| A7037 |
Tubing used with positive airway pressure device |
329 |
327 |
$8K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
46 |
46 |
$7K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
109 |
104 |
$5K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
117 |
111 |
$5K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
77 |
77 |
$5K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
33 |
33 |
$4K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
183 |
180 |
$4K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
58 |
58 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
118 |
118 |
$3K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
60 |
60 |
$3K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
159 |
156 |
$3K |
| E0156 |
Seat attachment, walker |
380 |
369 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
110 |
109 |
$2K |
| L3260 |
Surgical boot/shoe, each |
63 |
63 |
$1K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
246 |
238 |
$972.31 |
| K0003 |
Lightweight wheelchair |
14 |
13 |
$494.93 |
| A7031 |
Face mask interface, replacement for full face mask, each |
12 |
12 |
$289.39 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
42 |
41 |
$271.31 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
141 |
138 |
$183.51 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
12 |
12 |
$124.99 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
50 |
49 |
$0.82 |