| 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 |
5,228 |
5,202 |
$500K |
| E0601 |
Continuous positive airway pressure (cpap) device |
8,428 |
8,351 |
$476K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,989 |
1,953 |
$254K |
| 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) |
1,563 |
1,546 |
$181K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,903 |
1,891 |
$130K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
2,267 |
2,079 |
$93K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,579 |
1,559 |
$87K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
2,762 |
2,754 |
$79K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
6,087 |
6,043 |
$71K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,498 |
3,485 |
$70K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
1,082 |
1,056 |
$69K |
| E0570 |
Nebulizer, with compressor |
1,537 |
1,536 |
$64K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
346 |
336 |
$49K |
| A7035 |
Headgear used with positive airway pressure device |
2,425 |
2,409 |
$46K |
| A7037 |
Tubing used with positive airway pressure device |
2,439 |
2,421 |
$44K |
| K0001 |
Standard wheelchair |
1,762 |
1,745 |
$44K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,044 |
1,039 |
$43K |
| A7031 |
Face mask interface, replacement for full face mask, each |
736 |
732 |
$23K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,208 |
3,155 |
$21K |
| L3260 |
Surgical boot/shoe, each |
709 |
691 |
$13K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,758 |
1,751 |
$11K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
190 |
186 |
$9K |
| E0156 |
Seat attachment, walker |
427 |
420 |
$4K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
262 |
262 |
$4K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
68 |
65 |
$3K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
37 |
37 |
$518.82 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
143 |
90 |
$413.32 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
29 |
27 |
$374.24 |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
13 |
13 |
$368.00 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
41 |
41 |
$287.89 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
43 |
41 |
$210.40 |