| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
13,603 |
13,204 |
$893K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
2,538 |
2,377 |
$386K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
6,259 |
6,123 |
$370K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,950 |
2,904 |
$137K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
7,331 |
7,041 |
$124K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
900 |
840 |
$108K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,736 |
2,698 |
$95K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
502 |
494 |
$79K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
6,061 |
5,911 |
$78K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,001 |
989 |
$75K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
2,594 |
2,501 |
$66K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
937 |
906 |
$59K |
| K0001 |
Standard wheelchair |
2,998 |
2,944 |
$54K |
| K0003 |
Lightweight wheelchair |
1,658 |
1,596 |
$52K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,406 |
1,113 |
$46K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,341 |
4,237 |
$42K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
942 |
904 |
$39K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,418 |
1,399 |
$39K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
833 |
814 |
$37K |
| 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 |
664 |
628 |
$29K |
| 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) |
273 |
269 |
$27K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
474 |
461 |
$23K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
505 |
453 |
$22K |
| A7035 |
Headgear used with positive airway pressure device |
1,144 |
1,127 |
$16K |
| A7037 |
Tubing used with positive airway pressure device |
964 |
955 |
$14K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
3,110 |
3,026 |
$13K |
| L3807 |
Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
108 |
103 |
$11K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
78 |
78 |
$11K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
364 |
359 |
$10K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,123 |
2,097 |
$7K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
216 |
215 |
$7K |
| A7015 |
Aerosol mask, used with dme nebulizer |
5,900 |
5,690 |
$6K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
118 |
116 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
693 |
679 |
$5K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
167 |
149 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
498 |
489 |
$3K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
427 |
413 |
$2K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
50 |
25 |
$2K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
43 |
43 |
$1K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
173 |
172 |
$1K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
24 |
24 |
$919.68 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
37 |
36 |
$628.68 |
| K0002 |
Standard hemi (low seat) wheelchair |
25 |
25 |
$581.80 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
13 |
13 |
$395.37 |