| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 6 | 190 | 6,790 | $40 | $579.6K |
| E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | 9 | 80 | 860 | $410 | $521K |
| E0601 | Continuous positive airway pressure (CPAP) device | 5 | 190 | 1,920 | $40 | $195.3K |
| L0639 | Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces… | 2 | 10 | 90 | $510 | $186.8K |
| 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… | 9 | 20 | 260 | $210 | $152.3K |
| E2201 | Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches | 3 | 10 | 490 | $170 | $148.2K |
| 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… | 5 | 100 | 740 | $100 | $144.7K |
| E0730 | Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation | 3 | 40 | 410 | $100 | $140K |
| E0973 | Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each | 3 | 40 | 1,200 | $70 | $129.7K |
| E0570 | Nebulizer, with compressor | 17 | 190 | 1,270 | $40 | $121.4K |