| 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 |
217,410 |
209,204 |
$19.62M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
5,560 |
4,290 |
$5.07M |
| A7030 |
Full face mask used with positive airway pressure device, each |
42,429 |
41,196 |
$4.29M |
| E0601 |
Continuous positive airway pressure (cpap) device |
61,910 |
60,260 |
$3.95M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
4,707 |
4,309 |
$2.46M |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
65,728 |
64,119 |
$2.27M |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
34,356 |
33,526 |
$2.25M |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
33,879 |
32,743 |
$1.83M |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
9,546 |
9,253 |
$1.81M |
| A7031 |
Face mask interface, replacement for full face mask, each |
41,503 |
40,154 |
$1.75M |
| E0570 |
Nebulizer, with compressor |
48,948 |
47,239 |
$1.74M |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
10,088 |
9,763 |
$1.71M |
| A7035 |
Headgear used with positive airway pressure device |
67,376 |
65,759 |
$1.49M |
| 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) |
13,416 |
13,054 |
$1.47M |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
59,715 |
57,848 |
$1.24M |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
8,002 |
7,283 |
$1.21M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
11,621 |
10,906 |
$1.20M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
7,264 |
6,943 |
$1.08M |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
20,274 |
19,603 |
$1.01M |
| K0001 |
Standard wheelchair |
39,154 |
37,807 |
$979K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
10,198 |
9,672 |
$923K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
50,835 |
49,048 |
$871K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
8,407 |
7,956 |
$870K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
15,492 |
14,473 |
$845K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
4,872 |
4,352 |
$844K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
3,365 |
3,213 |
$646K |
| E1392 |
Portable oxygen concentrator, rental |
49,056 |
47,602 |
$614K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
11,200 |
10,790 |
$579K |
| T4541 |
Incontinence product, disposable underpad, large, each |
22,413 |
21,462 |
$506K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
85,015 |
82,389 |
$473K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
11,599 |
11,185 |
$459K |
| A4927 |
Gloves, non-sterile, per 100 |
27,701 |
25,121 |
$453K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
1,504 |
1,438 |
$452K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
41,512 |
40,387 |
$444K |
| A4623 |
Tracheostomy, inner cannula |
2,777 |
2,500 |
$439K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
12,469 |
12,131 |
$433K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
2,465 |
2,357 |
$400K |
| 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) |
1,309 |
1,263 |
$354K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
12,039 |
11,673 |
$346K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,713 |
2,585 |
$317K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,865 |
1,732 |
$316K |
| 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 |
2,499 |
2,353 |
$308K |
| K0007 |
Extra heavy duty wheelchair |
3,510 |
3,397 |
$297K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,395 |
2,277 |
$278K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
16,123 |
15,335 |
$274K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
2,022 |
1,945 |
$260K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,322 |
2,203 |
$258K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
1,535 |
1,500 |
$241K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,227 |
1,154 |
$235K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
6,636 |
6,388 |
$234K |
| E1399 |
Durable medical equipment, miscellaneous |
1,622 |
1,339 |
$227K |
| A7508 |
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each |
2,088 |
1,861 |
$224K |
| A7526 |
Tracheostomy tube collar/holder, each |
5,217 |
4,820 |
$216K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
6,719 |
6,386 |
$214K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,999 |
1,906 |
$195K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
4,372 |
4,110 |
$182K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
18,833 |
18,347 |
$180K |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
549 |
503 |
$179K |
| K0006 |
Heavy duty wheelchair |
3,367 |
3,250 |
$171K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
3,101 |
2,831 |
$167K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
306 |
257 |
$161K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
1,199 |
1,153 |
$156K |
| E0277 |
Powered pressure-reducing air mattress |
1,943 |
1,882 |
$145K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
5,761 |
5,575 |
$141K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
3,379 |
3,073 |
$140K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
2,855 |
1,378 |
$136K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
3,282 |
2,971 |
$133K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
2,822 |
2,714 |
$132K |
| A7037 |
Tubing used with positive airway pressure device |
6,172 |
5,993 |
$124K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
3,681 |
3,412 |
$123K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
612 |
507 |
$122K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
3,493 |
3,229 |
$122K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
1,573 |
1,478 |
$111K |
| E0550 |
Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery |
2,797 |
2,653 |
$105K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
766 |
688 |
$105K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
1,276 |
1,201 |
$101K |
| K0004 |
High strength, lightweight wheelchair |
1,422 |
1,366 |
$97K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
2,171 |
2,069 |
$97K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
2,161 |
2,072 |
$95K |
| W0137 |
|
3,483 |
3,348 |
$92K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
752 |
697 |
$83K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
716 |
675 |
$81K |
| E0248 |
Transfer bench, heavy duty, for tub or toilet with or without commode opening |
549 |
496 |
$79K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
1,119 |
983 |
$77K |
| A4605 |
Tracheal suction catheter, closed system, each |
415 |
364 |
$75K |
| A7000 |
Canister, disposable, used with suction pump, each |
7,224 |
6,680 |
$75K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
677 |
645 |
$74K |
| K0462 |
Temporary replacement for patient owned equipment being repaired, any type |
977 |
915 |
$71K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
1,415 |
1,344 |
$70K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
827 |
798 |
$66K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
7,179 |
6,413 |
$63K |
| A7020 |
Interface for cough stimulating device, includes all components, replacement only |
2,015 |
1,899 |
$62K |
| A4335 |
Incontinence supply; miscellaneous |
3,705 |
3,129 |
$57K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
3,549 |
3,443 |
$55K |
| A4670 |
Automatic blood pressure monitor |
975 |
955 |
$54K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
521 |
450 |
$50K |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
326 |
287 |
$48K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
657 |
616 |
$46K |
| L0641 |
Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
907 |
864 |
$46K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
861 |
795 |
$41K |
| A7036 |
Chinstrap used with positive airway pressure device |
3,654 |
3,589 |
$39K |
| L8501 |
Tracheostomy speaking valve |
626 |
586 |
$39K |
| E0168 |
Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each |
793 |
742 |
$38K |
| A4452 |
Tape, waterproof, per 18 square inches |
2,093 |
2,039 |
$38K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
3,640 |
3,473 |
$38K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
1,342 |
1,304 |
$37K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,029 |
949 |
$37K |
| E0156 |
Seat attachment, walker |
3,842 |
3,676 |
$36K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
728 |
688 |
$36K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
7,574 |
5,808 |
$34K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
4,910 |
4,552 |
$34K |
| A6223 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing |
608 |
520 |
$34K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
622 |
585 |
$33K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
309 |
270 |
$33K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,784 |
2,593 |
$31K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
2,711 |
2,587 |
$30K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
4,185 |
3,763 |
$30K |
| A4427 |
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each |
625 |
586 |
$28K |
| E0940 |
Trapeze bar, free standing, complete with grab bar |
2,385 |
2,237 |
$26K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
1,107 |
958 |
$25K |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
609 |
586 |
$25K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
2,606 |
2,223 |
$25K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
403 |
390 |
$23K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
404 |
383 |
$23K |
| A6198 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing |
51 |
38 |
$23K |
| A4554 |
Disposable underpads, all sizes |
2,585 |
2,035 |
$23K |
| E0635 |
Patient lift, electric with seat or sling |
918 |
881 |
$21K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,679 |
1,540 |
$19K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
937 |
793 |
$18K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
573 |
480 |
$18K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
177 |
166 |
$17K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
1,785 |
1,698 |
$17K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
1,324 |
1,126 |
$16K |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
266 |
240 |
$16K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,389 |
2,293 |
$15K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
202 |
179 |
$15K |
| A4553 |
Non-disposable underpads, all sizes |
514 |
395 |
$14K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
958 |
872 |
$14K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,577 |
1,479 |
$13K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
111 |
108 |
$12K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
322 |
283 |
$12K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,358 |
1,303 |
$12K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
5,211 |
4,932 |
$12K |
| A7002 |
Tubing, used with suction pump, each |
2,291 |
2,070 |
$11K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
649 |
614 |
$11K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
417 |
311 |
$11K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
4,175 |
3,812 |
$10K |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
694 |
612 |
$10K |
| E0244 |
Raised toilet seat |
255 |
230 |
$10K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
2,015 |
1,858 |
$10K |
| A4332 |
Lubricant, individual sterile packet, each |
1,361 |
1,247 |
$10K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
602 |
552 |
$10K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
1,185 |
1,121 |
$9K |
| 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 |
210 |
192 |
$8K |
| A6220 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
133 |
116 |
$6K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
749 |
689 |
$6K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
340 |
318 |
$6K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
1,908 |
1,771 |
$6K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
154 |
141 |
$5K |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
250 |
230 |
$5K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
519 |
488 |
$5K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
51 |
48 |
$5K |
| A4245 |
Alcohol wipes, per box |
269 |
245 |
$4K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
285 |
271 |
$4K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
13 |
13 |
$3K |
| A4660 |
Sphygmomanometer/blood pressure apparatus with cuff and stethoscope |
109 |
98 |
$3K |
| E1039 |
Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds |
227 |
214 |
$3K |
| A4371 |
Ostomy skin barrier, powder, per oz |
878 |
842 |
$3K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
96 |
91 |
$3K |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
498 |
477 |
$3K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
13 |
13 |
$2K |
| K0003 |
Lightweight wheelchair |
100 |
100 |
$2K |
| E0484 |
Oscillatory positive expiratory pressure device, non-electric, any type, each |
119 |
113 |
$2K |
| A4618 |
Breathing circuits |
92 |
85 |
$2K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
47 |
41 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,686 |
1,605 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
967 |
759 |
$1K |
| A6456 |
Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
19 |
12 |
$1K |
| A6441 |
Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard |
49 |
37 |
$901.59 |
| A4367 |
Ostomy belt, each |
99 |
87 |
$861.81 |
| E0912 |
Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar |
79 |
71 |
$789.83 |
| E0705 |
Transfer device, any type, each |
27 |
27 |
$606.27 |
| A7525 |
Tracheostomy mask, each |
2,366 |
2,158 |
$549.91 |
| A6407 |
Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard |
35 |
32 |
$423.00 |
| A4402 |
Lubricant, per ounce |
45 |
39 |
$238.18 |
| E0184 |
Dry pressure mattress |
12 |
12 |
$234.46 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
280 |
266 |
$186.38 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
60 |
48 |
$162.59 |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
13 |
12 |
$142.82 |
| E1020 |
Residual limb support system for wheelchair, any type |
14 |
12 |
$98.84 |
| E0315 |
Bed accessory: board, table, or support device, any type |
20 |
20 |
$93.50 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
17 |
13 |
$7.53 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
24 |
22 |
$0.00 |