| 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 |
3,620 |
3,220 |
$245K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
618 |
565 |
$137K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,410 |
2,231 |
$103K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,007 |
1,757 |
$92K |
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
758 |
260 |
$87K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,748 |
1,416 |
$71K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,438 |
1,357 |
$48K |
| A7030 |
Full face mask used with positive airway pressure device, each |
559 |
513 |
$47K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,479 |
1,302 |
$42K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,233 |
2,808 |
$33K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
524 |
451 |
$31K |
| E0570 |
Nebulizer, with compressor |
948 |
804 |
$28K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
194 |
174 |
$25K |
| K0001 |
Standard wheelchair |
1,396 |
1,209 |
$24K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
748 |
609 |
$22K |
| A7035 |
Headgear used with positive airway pressure device |
675 |
617 |
$13K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
100 |
89 |
$10K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
241 |
214 |
$7K |
| 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 |
82 |
74 |
$7K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
76 |
71 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
322 |
298 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,090 |
1,008 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
28 |
25 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
195 |
172 |
$1K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
14 |
14 |
$941.82 |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
13 |
13 |
$735.91 |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
41 |
36 |
$503.36 |
| A7031 |
Face mask interface, replacement for full face mask, each |
19 |
14 |
$476.33 |