| 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 |
20,069 |
16,304 |
$442K |
| A7030 |
Full face mask used with positive airway pressure device, each |
10,749 |
8,773 |
$377K |
| E0601 |
Continuous positive airway pressure (cpap) device |
17,140 |
14,377 |
$376K |
| A7031 |
Face mask interface, replacement for full face mask, each |
17,731 |
13,782 |
$260K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
687 |
508 |
$249K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
1,619 |
1,396 |
$209K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
6,291 |
5,042 |
$149K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
627 |
516 |
$127K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
16,899 |
14,026 |
$127K |
| E0483 |
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each |
550 |
452 |
$121K |
| E0570 |
Nebulizer, with compressor |
13,254 |
11,775 |
$118K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
7,168 |
5,360 |
$110K |
| A7037 |
Tubing used with positive airway pressure device |
12,410 |
10,011 |
$83K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,523 |
3,706 |
$78K |
| A7035 |
Headgear used with positive airway pressure device |
9,566 |
7,836 |
$74K |
| 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) |
1,328 |
1,141 |
$67K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
29,979 |
23,334 |
$63K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
3,166 |
2,537 |
$46K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,829 |
2,340 |
$44K |
| K0001 |
Standard wheelchair |
7,634 |
5,978 |
$43K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
316 |
214 |
$41K |
| L3984 |
Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment |
232 |
180 |
$38K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,602 |
6,104 |
$37K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
690 |
530 |
$30K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
2,666 |
2,173 |
$27K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
5,569 |
4,563 |
$26K |
| K0003 |
Lightweight wheelchair |
3,534 |
2,795 |
$24K |
| E1392 |
Portable oxygen concentrator, rental |
4,000 |
3,156 |
$23K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
247 |
221 |
$21K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
835 |
729 |
$20K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
7,158 |
5,806 |
$20K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,843 |
1,506 |
$20K |
| K0006 |
Heavy duty wheelchair |
789 |
655 |
$15K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
319 |
284 |
$14K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
1,267 |
1,036 |
$14K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
474 |
402 |
$13K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
827 |
663 |
$9K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,329 |
1,129 |
$9K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,297 |
1,852 |
$7K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
101 |
88 |
$6K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
931 |
642 |
$5K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
1,111 |
782 |
$5K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
7,011 |
2,641 |
$5K |
| A6550 |
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories |
90 |
49 |
$4K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
9,427 |
3,499 |
$3K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
19 |
12 |
$3K |
| 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 |
48 |
39 |
$3K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
907 |
764 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
8,042 |
2,988 |
$2K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
55 |
37 |
$2K |
| A7000 |
Canister, disposable, used with suction pump, each |
117 |
61 |
$2K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
409 |
323 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
7,374 |
2,805 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
732 |
649 |
$937.03 |
| E0305 |
Bed side rails, half length |
886 |
735 |
$844.71 |
| E0156 |
Seat attachment, walker |
195 |
160 |
$672.94 |
| L2810 |
Addition to lower extremity orthosis, knee control, condylar pad |
17 |
12 |
$628.24 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
89 |
56 |
$594.63 |
| A7036 |
Chinstrap used with positive airway pressure device |
113 |
95 |
$566.89 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
197 |
167 |
$498.73 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
53 |
38 |
$298.60 |