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        Most Medicare DME is covered under Part B although sometimes

               Part A will pay for item when you are in a hospital setting.

Here are some of the most common DME items:

  • Hospital beds, canes, walkers, crutches and commode chairs

  • Wheelchair and power mobility devices

  • Nebulizers and the medications used in them

  • Home Oxygen equipment and accessories

  • Sleep Apnea devices and accessories

  • Infusion pumps and supplies

  • Blood glucose monitors and test strips for diabetes self-testing

  • Some incontinence products, such as catheters, Adult Diapers

  • Braces such as Medicare back brace or Medicare knee brace 

  • DME Codes and descriptions with covered price

A4206   SYRINGE WITH NEEDLE, STERILE, 1 CC OR LESS, EACH    DME$0.39

A4208  SYRINGE WITH NEEDLE, STERILE 3 CC, EACH    DME$0.39

A4209  SYRINGE WITH NEEDLE, STERILE 5 CC OR GREATER, EACH    DME$0.40

A4213  SYRINGE, STERILE, 20 CC OR GREATER, EACH    DME$0.78

A4221  SUPPLIES FOR MAINTENANCE OF NON-INSULIN DRUG INFUSION CATHETER, PER WEEK (LIST DRUGS  SEPARATELY)    DME$22.01

A4222   INFUSION SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)    DME$42.81

A4223INFUSION SUPPLIES NOT USED WITH EXTERNAL INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)    DME$43.86

A4224SUPPLIES FOR MAINTENANCE OF INSULIN INFUSION CATHETER, PER WEEK    DME$19.40

A4225SUPPLIES FOR EXTERNAL INSULIN INFUSION PUMP, SYRINGE TYPE CARTRIDGE, STERILE, EACH    DME$2.60

A4230INFUSION SET FOR EXTERNAL INSULIN PUMP, NON NEEDLE CANNULA TYPE    DME$10.00

A4231INFUSION SET FOR EXTERNAL INSULIN PUMP, NEEDLE TYPE    DME$5.06

A4232SYRINGE WITH NEEDLE FOR EXTERNAL INSULIN PUMP, STERILE, 3 CC    DME$2.59

A4244ALCOHOL OR PEROXIDE, PER PINT    DME$0.78

A4245ALCOHOL WIPES, PER BOX    DME$2.35

A4246BETADINE OR PHISOHEX SOLUTION, PER PINT    DME$2.75

A4280ADHESIVE SKIN SUPPORT ATTACHMENT FOR USE WITH EXTERNAL BREAST PROSTHESIS, EACH    DME$5.74

A4305DISPOSABLE DRUG DELIVERY SYSTEM, FLOW RATE OF 50 ML OR GREATER PER HOUR    DME$13.32

A4306DISPOSABLE DRUG DELIVERY SYSTEM, FLOW RATE OF LESS THAN 50 ML PER HOUR    DME$18.41

 

A5120SKIN BARRIER, WIPES OR SWABS, EACH    DME$0.26

A5120SKIN BARRIER, WIPES OR SWABS, EACHAU  DME$0.24

A5120SKIN BARRIER, WIPES OR SWABS, EACHAV  DME$0.26

A5121SKIN BARRIER; SOLID, 6 X 6 OR EQUIVALENT, EACH    DME$7.43

A5122SKIN BARRIER; SOLID, 8 X 8 OR EQUIVALENT, EACH    DME$14.20

A5126ADHESIVE OR NON-ADHESIVE; DISK OR FOAM PAD    DME$1.45

A5131APPLIANCE CLEANER, INCONTINENCE AND OSTOMY APPLIANCES, PER 16 OZ.    DME$15.23

A5200PERCUTANEOUS CATHETER/TUBE ANCHORING DEVICE, ADHESIVE SKIN ATTACHMENT    DME$12.48

A5500FOR DIABETICS ONLY, FITTING (INCLUDING FOLLOW-UP), CUSTOM PREPARATION AND SUPPLY OF OFF-THE-SHELF DEPTH-INLAY SHOE MANUFACTURED TO ACCOMMODATE MULTI-DENSITY INSERT(S), PER SHOE    DME$70.29

A5501FOR DIABETICS ONLY, FITTING (INCLUDING FOLLOW-UP), CUSTOM PREPARATION AND SUPPLY OF SHOE MOLDED FROM CAST(S) OF PATIENT'S FOOT (CUSTOM MOLDED SHOE), PER SHOE    DME$210.83

A5503FOR DIABETICS ONLY, MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE WITH ROLLER OR RIGID ROCKER BOTTOM, PER SHOE    DME$34.55

A5504FOR DIABETICS ONLY, MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE WITH WEDGE(S), PER SHOE    DME$34.55

A5505FOR DIABETICS ONLY, MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE WITH METATARSAL BAR, PER SHOE    DME$34.55

A5506FOR DIABETICS ONLY, MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE WITH OFF-SET HEEL(S), PER SHOE    DME$34.55

A5507FOR DIABETICS ONLY, NOT OTHERWISE SPECIFIED MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE, PER SHOE    DME$34.55

A5512FOR DIABETICS ONLY, MULTIPLE DENSITY INSERT, DIRECT FORMED, MOLDED TO FOOT AFTER EXTERNAL HEAT SOURCE OF 230 DEGREES FAHRENHEIT OR HIGHER, TOTAL CONTACT WITH PATIENT'S FOOT, INCLUDING ARCH, BASE LAYER MINIMUM OF 1/4 INCH MATERIAL OF SHORE A 35 DUROMETER OR 3/16 INCH MATERIAL OF SHORE A 40 DUROMETER (OR HIGHER), PREFABRICATED, EACH    DME$28.67

A5513FOR DIABETICS ONLY, MULTIPLE DENSITY INSERT, CUSTOM MOLDED FROM MODEL OF PATIENT'S FOOT, TOTAL CONTACT WITH PATIENT'S FOOT, INCLUDING ARCH, BASE LAYER MINIMUM OF 3/16 INCH MATERIAL OF SHORE A 35 DUROMETER (OR HIGHER), INCLUDES ARCH FILLER AND OTHER SHAPING MATERIAL, CUSTOM FABRICATED, EACH    DME$42.79

A5514FOR DIABETICS ONLY, MULTIPLE DENSITY INSERT, MADE BY DIRECT CARVING WITH CAM TECHNOLOGY FROM A RECTIFIED CAD MODEL CREATED FROM A DIGITIZED SCAN OF THE PATIENT, TOTAL CONTACT WITH PATIENT'S FOOT, INCLUDING ARCH, BASE LAYER MINIMUM OF 3/16 INCH MATERIAL OF SHORE A 35 DUROMETER (OR HIGHER), INCLUDES ARCH FILLER AND OTHER SHAPING MATERIAL, CUSTOM FABRICATED, EACH    DME$44.56

A6010COLLAGEN BASED WOUND FILLER, DRY FORM, STERILE, PER GRAM OF COLLAGEN    DME$34.24

A6011COLLAGEN BASED WOUND FILLER, GEL/PASTE, PER GRAM OF COLLAGEN    DME$2.52

A6021COLLAGEN DRESSING, STERILE, SIZE 16 SQ. IN. OR LESS, EACH    DME$23.24

A6022COLLAGEN DRESSING, STERILE, SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH    DME$23.24

A6023COLLAGEN DRESSING, STERILE, SIZE MORE THAN 48 SQ. IN., EACH    DME$210.39

A6024COLLAGEN DRESSING WOUND FILLER, STERILE, PER 6 INCHES    DME$6.84

A6025GEL SHEET FOR DERMAL OR EPIDERMAL APPLICATION, (E.G., SILICONE, HYDROGEL, OTHER), EACH    DME$21.56

A6154WOUND POUCH, EACH    DME$15.88

A6196ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, EACH DRESSING    DME$8.13

A6197ALGINATE 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    DME$18.17

A6199ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND FILLER, STERILE, PER 6 INCHES    DME$5.85

A6203COMPOSITE DRESSING, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING    DME$3.72

A6204COMPOSITE DRESSING, STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING    DME$6.88

A6207CONTACT LAYER, STERILE, MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING    DME$8.11

A6209FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$8.26

A6210FOAM 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    DME$22.03

A6211FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$32.47

A6212FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING    DME$10.73

A6214FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING    DME$11.37

A6216GAUZE, NON-IMPREGNATED, NON-STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$0.05

A6219GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING    DME$1.06

A6220GAUZE, 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    DME$2.86

A6222GAUZE, IMPREGNATED WITH OTHER THAN WATER, NORMAL SALINE, OR HYDROGEL, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$2.35

A6223GAUZE, 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    DME$2.68

A6224GAUZE, IMPREGNATED WITH OTHER THAN WATER, NORMAL SALINE, OR HYDROGEL, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$3.99

A6229GAUZE, IMPREGNATED, WATER OR NORMAL SALINE, STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$3.99

A6231GAUZE, IMPREGNATED, HYDROGEL, FOR DIRECT WOUND CONTACT, STERILE, PAD SIZE 16 SQ. IN. OR LESS, EACH DRESSING    DME$5.18

A6232GAUZE, IMPREGNATED, HYDROGEL, FOR DIRECT WOUND CONTACT, STERILE, PAD SIZE GREATER THAN 16 SQ. IN., BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING    DME$7.59

A6233GAUZE, IMPREGNATED, HYDROGEL, FOR DIRECT WOUND CONTACT, STERILE, PAD SIZE MORE THAN 48 SQ. IN., EACH DRESSING    DME$21.20

A6234HYDROCOLLOID DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$7.23

A6235HYDROCOLLOID 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    DME$18.59

A6236HYDROCOLLOID DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$30.13

A6237HYDROCOLLOID DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING    DME$8.75

A6238HYDROCOLLOID 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    DME$25.20

A6240HYDROCOLLOID DRESSING, WOUND FILLER, PASTE, STERILE, PER OUNCE    DME$13.54

A6241HYDROCOLLOID DRESSING, WOUND FILLER, DRY FORM, STERILE, PER GRAM    DME$2.84

A6242HYDROGEL DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$6.70

A6243HYDROGEL 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    DME$13.62

A6244HYDROGEL DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$43.43

A6245HYDROGEL DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING    DME$8.03

A6246HYDROGEL 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    DME$10.98

A6247HYDROGEL DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING    DME$26.29

A6248HYDROGEL DRESSING, WOUND FILLER, GEL, PER FLUID OUNCE    DME$17.96

A6251SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$2.20

A6252SPECIALTY 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    DME$3.60

A6253SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$7.00

A6254SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING    DME$1.33

A6255SPECIALTY ABSORPTIVE 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    DME$3.36

A6257TRANSPARENT FILM, STERILE, 16 SQ. IN. OR LESS, EACH DRESSING    DME$1.70

A6258TRANSPARENT FILM, STERILE, MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING    DME$4.77

A6259TRANSPARENT FILM, STERILE, MORE THAN 48 SQ. IN., EACH DRESSING    DME$12.10

A6261WOUND FILLER, GEL/PASTE, PER FLUID OUNCE, NOT OTHERWISE SPECIFIED    DME$3.54

A6266GAUZE, IMPREGNATED, OTHER THAN WATER, NORMAL SALINE, OR ZINC PASTE, STERILE, ANY WIDTH, PER LINEAR YARD    DME$2.13

A6402GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$0.13

A6403GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE MORE THAN 16 SQ. IN. LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING    DME$0.47

A6407PACKING STRIPS, NON-IMPREGNATED, STERILE, UP TO 2 INCHES IN WIDTH, PER LINEAR YARD    DME$2.08

A6410EYE PAD, STERILE, EACH    DME$0.43

A6441PADDING BANDAGE, NON-ELASTIC, NON-WOVEN/NON-KNITTED, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD    DME$0.75

A6442CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, NON-STERILE, WIDTH LESS THAN THREE INCHES, PER YARD    DME$0.18

A6443CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, NON-STERILE, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD    DME$0.31

A6444CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, NON-STERILE, WIDTH GREATER THAN OR EQUAL TO 5 INCHES, PER YARD    DME$0.62

A6445CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, STERILE, WIDTH LESS THAN THREE INCHES, PER YARD    DME$0.36

A6446CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, STERILE, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD    DME$0.45

A6447CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, STERILE, WIDTH GREATER THAN OR EQUAL TO FIVE INCHES, PER YARD    DME$0.75

A6448LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, WIDTH LESS THAN THREE INCHES, PER YARD    DME$1.28

A6449LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD    DME$1.94

A6451MODERATE COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, LOAD RESISTANCE OF 1.25 TO 1.34 FOOT POUNDS AT 50% MAXIMUM STRETCH, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD    DEF$1.94

A6452HIGH COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, LOAD RESISTANCE GREATER THAN OR EQUAL TO 1.35 FOOT POUNDS AT 50% MAXIMUM STRETCH, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD    DME$6.53

A6453SELF-ADHERENT BANDAGE, ELASTIC, NON-KNITTED/NON-WOVEN, WIDTH LESS THAN THREE INCHES, PER YARD    DME$0.69

A6454SELF-ADHERENT BANDAGE, ELASTIC, NON-KNITTED/NON-WOVEN, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD    DME$0.86

A6455SELF-ADHERENT BANDAGE, ELASTIC, NON-KNITTED/NON-WOVEN, WIDTH GREATER THAN OR EQUAL TO FIVE INCHES, PER YARD    DME$1.54

A6456ZINC PASTE IMPREGNATED BANDAGE, NON-ELASTIC, KNITTED/WOVEN, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD    DME$1.40

A6457TUBULAR DRESSING WITH OR WITHOUT ELASTIC, ANY WIDTH, PER LINEAR YARD    DME$1.26

A6530GRADIENT COMPRESSION STOCKING, BELOW KNEE, 18-30 MMHG, EACH    DME$24.83

A6531GRADIENT COMPRESSION STOCKING, BELOW KNEE, 30-40 MMHG, EACH    DME$47.83

A6532GRADIENT COMPRESSION STOCKING, BELOW KNEE, 40-50 MMHG, EACH    DME$67.39

A6533GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 18-30 MMHG, EACH    DME$29.79

A6534GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 30-40 MMHG, EACH    DME$29.79

A6535GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 40-50 MMHG, EACH    DME$29.79

A6536GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 18-30 MMHG, EACH    DME$39.72

A6537GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 30-40 MMHG, EACH    DME$39.72

A6538GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 40-50 MMHG, EACH    DME$39.72

A6539GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 18-30 MMHG, EACH    DME$79.44

A6540GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 30-40 MMHG, EACH    DME$79.44

A6541GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 40-50 MMHG, EACH    DME$79.44

A6544GRADIENT COMPRESSION STOCKING, GARTER BELT    DME$13.90

A6545GRADIENT COMPRESSION WRAP, NON-ELASTIC, BELOW KNEE, 30-50 MM HG, EACH    DEF$94.17

A6550WOUND CARE SET, FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, INCLUDES ALL SUPPLIES AND ACCESSORIES    DME$24.36

A7000CANISTER, DISPOSABLE, USED WITH SUCTION PUMP, EACHNU  DME$8.54

A7000CANISTER, DISPOSABLE, USED WITH SUCTION PUMP, EACHNUKEDME$9.27

A7001CANISTER, NON-DISPOSABLE, USED WITH SUCTION PUMP, EACHNU  DME$36.56

A7002TUBING, USED WITH SUCTION PUMP, EACHNU  DME$4.23

A7003ADMINISTRATION SET, WITH SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, DISPOSABLENU  DME$2.27

A7004SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, DISPOSABLENU  DME$1.62

A7005ADMINISTRATION SET, WITH SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, NON-DISPOSABLENU  DME$22.37

A7006ADMINISTRATION SET, WITH SMALL VOLUME FILTERED PNEUMATIC NEBULIZERNU  DME$8.49

A7009RESERVOIR BOTTLE, NON-DISPOSABLE, USED WITH LARGE VOLUME ULTRASONIC NEBULIZERNU  DME$46.48

A7010CORRUGATED TUBING, DISPOSABLE, USED WITH LARGE VOLUME NEBULIZER, 100 FEETNU  DME$20.34

A7012WATER COLLECTION DEVICE, USED WITH LARGE VOLUME NEBULIZERNU  DME$3.45

A7013FILTER, DISPOSABLE, USED WITH AEROSOL COMPRESSOR OR ULTRASONIC GENERATORNU  DME$0.72

A7014FILTER, NONDISPOSABLE, USED WITH AEROSOL COMPRESSOR OR ULTRASONIC GENERATORNU  DME$4.01

A7015AEROSOL MASK, USED WITH DME NEBULIZERNU  DME$1.62

A7016DOME AND MOUTHPIECE, USED WITH SMALL VOLUME ULTRASONIC NEBULIZERNU  DME$8.01

A7017NEBULIZER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC, BOTTLE TYPE, NOT USED WITH OXYGENNU  DME$129.57

A7017NEBULIZER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC, BOTTLE TYPE, NOT USED WITH OXYGENRR  DME$12.96

A7017NEBULIZER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC, BOTTLE TYPE, NOT USED WITH OXYGENUE  DME$97.18

A7018WATER, DISTILLED, USED WITH LARGE VOLUME NEBULIZER, 1000 ML    DME$0.36

A7020INTERFACE FOR COUGH STIMULATING DEVICE, INCLUDES ALL COMPONENTS, REPLACEMENT ONLYNU  DME$15.42

A7025HIGH FREQUENCY CHEST WALL OSCILLATION SYSTEM VEST, REPLACEMENT FOR USE WITH PATIENT OWNED EQUIPMENT, EACH    DME$480.90

A7026HIGH FREQUENCY CHEST WALL OSCILLATION SYSTEM HOSE, REPLACEMENT FOR USE WITH PATIENT OWNED EQUIPMENT, EACHNU  DME$31.78

A7027COMBINATION ORAL/NASAL MASK, USED WITH CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE, EACHNU  DME$159.25

A7028ORAL CUSHION FOR COMBINATION ORAL/NASAL MASK, REPLACEMENT ONLY, EACHNU  DME$43.92

A7029NASAL PILLOWS FOR COMBINATION ORAL/NASAL MASK, REPLACEMENT ONLY, PAIRNU  DME$18.85

A7030FULL FACE MASK USED WITH POSITIVE AIRWAY PRESSURE DEVICE, EACHNU  DME$133.49

A7031FACE MASK INTERFACE, REPLACEMENT FOR FULL FACE MASK, EACHNU  DME$50.02

A7032CUSHION FOR USE ON NASAL MASK INTERFACE, REPLACEMENT ONLY, EACHNU  DME$28.73

A7033PILLOW FOR USE ON NASAL CANNULA TYPE INTERFACE, REPLACEMENT ONLY, PAIRNU  DME$21.21

A7034NASAL INTERFACE (MASK OR CANNULA TYPE) USED WITH POSITIVE AIRWAY PRESSURE DEVICE, WITH OR WITHOUT HEAD STRAPNU  DME$83.37

A7035HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICENU  DME$28.10

A7036CHINSTRAP USED WITH POSITIVE AIRWAY PRESSURE DEVICENU  DME$14.05

A7037TUBING USED WITH POSITIVE AIRWAY PRESSURE DEVICENU  DME$25.85

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E0116 CRUTCH, UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, WITH PAD, TIP, HANDGRIP, WITH OR WITHOUT SHOCK ABSORBER, EACHUE  DME $19.63

E0117 CRUTCH, UNDERARM, ARTICULATING, SPRING ASSISTED, EACH    DME  $212.90

E0117 CRUTCH, UNDERARM, ARTICULATING, SPRING ASSISTED, EACHRR  DME  $21.29

E0117 CRUTCH, UNDERARM, ARTICULATING, SPRING ASSISTED, EACHUE  DME  $159.68

E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHTNU  DME  $56.97

E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHTRR  DME  $10.36

E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHTUE  DME  $43.71

E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHTNU  DME  $62.33

E0135WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHTRR  DME  $10.46

E0135WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHTUE  DME  $47.43

E0140WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE    DME  $301.30

E0140WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPERR  DME $30.13

E0140WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPEUE  DME  $225.98

E0141WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHTNU  DME$92.78

E0141WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHTRR  DME$14.47

E0141WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHTUE  DME$69.59

E0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHTNU  DME$80.58

E0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHTRR  DME$12.62

E0143WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHTUE  DME$60.35

E0148WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACHNU  DME$100.09

E0148WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACHRR  DME$10.02

E0148WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACHUE  DME$75.06

E0149WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE    DME$165.90

E0149WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPERR  DME$16.59

E0149WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPEUE  DME$124.43

E0153PLATFORM ATTACHMENT, FOREARM CRUTCH, EACHNU  DME$76.71

E0153PLATFORM ATTACHMENT, FOREARM CRUTCH, EACHRR  DME$8.67

E0153PLATFORM ATTACHMENT, FOREARM CRUTCH, EACHUE  DME$57.52

E0154PLATFORM ATTACHMENT, WALKER, EACHNU  DME$56.32

E0154PLATFORM ATTACHMENT, WALKER, EACHRR  DME$6.35

E0154PLATFORM ATTACHMENT, WALKER, EACHUE  DME$34.09

E0168COMMODE CHAIR, EXTRA WIDE AND/OR HEAVY DUTY, STATIONARY OR MOBILE, WITH OR WITHOUT ARMS, ANY TYPE, EACHNU  DME$137.65

E0168COMMODE CHAIR, EXTRA WIDE AND/OR HEAVY DUTY, STATIONARY OR MOBILE, WITH OR WITHOUT ARMS, ANY TYPE, EACHRR  DME$13.76

E0168COMMODE CHAIR, EXTRA WIDE AND/OR HEAVY DUTY, STATIONARY OR MOBILE, WITH OR WITHOUT ARMS, ANY TYPE, EACHUE  DME$103.23

E0181POWERED PRESSURE REDUCING MATTRESS OVERLAY/PAD, ALTERNATING, WITH PUMP, INCLUDES HEAVY DUTY    DME$212.90

E0181POWERED PRESSURE REDUCING MATTRESS OVERLAY/PAD, ALTERNATING, WITH PUMP, INCLUDES HEAVY DUTYMS  DME$21.99

E0181POWERED PRESSURE REDUCING MATTRESS OVERLAY/PAD, ALTERNATING, WITH PUMP, INCLUDES HEAVY DUTYRR  DME$21.99

E0182PUMP FOR ALTERNATING PRESSURE PAD, FOR REPLACEMENT ONLY    DME$244.90

E0182PUMP FOR ALTERNATING PRESSURE PAD, FOR REPLACEMENT ONLYMS  DME$24.49

E0182PUMP FOR ALTERNATING PRESSURE PAD, FOR REPLACEMENT ONLYRR  DME$24.49

E0184DRY PRESSURE MATTRESSNU  DME$168.10

E0184DRY PRESSURE MATTRESSRR  DME$19.21

E0184DRY PRESSURE MATTRESSUE  DME$127.63

E0185GEL OR GEL-LIKE PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHNU  DME$228.96

E0185GEL OR GEL-LIKE PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHRR  DME$28.99

E0185GEL OR GEL-LIKE PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHUE  DME$174.35

E0186AIR PRESSURE MATTRESS    DME$202.40

E0186AIR PRESSURE MATTRESSMS  DME$20.54

E0186AIR PRESSURE MATTRESSRR  DME$20.54

E0187WATER PRESSURE MATTRESS    DME$235.00

E0187WATER PRESSURE MATTRESSMS  DME$23.50

E0187WATER PRESSURE MATTRESSRR  DME$23.50

E0191HEEL OR ELBOW PROTECTOR, EACHNU  DME$9.39

E0191HEEL OR ELBOW PROTECTOR, EACHRR  DME$1.14

E0191HEEL OR ELBOW PROTECTOR, EACHUE  DME$7.00

E0193POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY)MS  DME$744.27

E0193POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY)RR  DME$744.27

E0194AIR FLUIDIZED BEDMS  DME$3,597.70

E0194AIR FLUIDIZED BEDRR  DME$3,597.70

E0196GEL PRESSURE MATTRESS    DME$303.40

E0196GEL PRESSURE MATTRESSMS  DME$30.34

E0196GEL PRESSURE MATTRESSRR  DME$30.34

E0197AIR PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH    DME$227.80

E0197AIR PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHRR  DME$22.78

E0197AIR PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHUE  DME$170.85

E0198WATER PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH    DME$242.30

E0198WATER PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHRR  DME$24.23

E0198WATER PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHUE  DME$181.73

E0199DRY PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHNU  DME$32.48

E0199DRY PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHRR  DME$3.24

E0199DRY PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHUE  DME$24.36

E0202PHOTOTHERAPY (BILIRUBIN) LIGHT WITH PHOTOMETERRR  DME$59.42

E0240BATH/SHOWER CHAIR, WITH OR WITHOUT WHEELS, ANY SIZE    DME$44.69

E0244RAISED TOILET SEAT    DME$44.69

E0245TUB STOOL OR BENCH    DME$79.44

E0247TRANSFER BENCH FOR TUB OR TOILET WITH OR WITHOUT COMMODE OPENING    DME$79.44

E0325URINAL; MALE, JUG-TYPE, ANY MATERIALNU  DME$8.15

E0325URINAL; MALE, JUG-TYPE, ANY MATERIALRR  DME$0.81

E0325URINAL; MALE, JUG-TYPE, ANY MATERIALUE  DME$6.11

E0326URINAL; FEMALE, JUG-TYPE, ANY MATERIALNU  DME$9.70

E0326URINAL; FEMALE, JUG-TYPE, ANY MATERIALRR  DME$0.97

E0326URINAL; FEMALE, JUG-TYPE, ANY MATERIALUE  DME$7.28

E0371NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH    DME$3,214.90

E0371NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHMS  DME$321.49

E0371NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHRR  DME$321.49

E0372POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH    DME$3,557.60

E0372POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHMS  DME$355.76

E0372POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTHRR  DME$355.76

E0373NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS    DME$4,433.40

E0373NONPOWERED ADVANCED PRESSURE REDUCING MATTRESSMS  DME$443.34

E0373  NON POWERED ADVANCED PRESSURE REDUCING MATTRESSRR  DME $443.34

E0424  STATIONARY COMPRESSED GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES CONTAINER, CONTENTS, REGULATOR, FLOWMETER, HUMIDIFIER, NEBULIZER, CANNULA OR MASK, AND TUBINGRR  DME$123.58

E0430 PORTABLE GASEOUS OXYGEN SYSTEM, PURCHASE; INCLUDES REGULATOR, FLOWMETER, HUMIDIFIER, CANNULA OR MASK, AND TUBING    DME $214.31

E0431  PORTABLE GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, REGULATOR, FLOWMETER, HUMIDIFIER, CANNULA OR MASK, AND TUBINGRR  DME$23.72

E0439 STATIONARY LIQUID OXYGEN SYSTEM, RENTAL; INCLUDES CONTAINER, CONTENTS, REGULATOR, FLOWMETER, HUMIDIFIER, NEBULIZER, CANNULA OR MASK, & TUBINGRR  DME $123.58

E0637COMBINATION SIT TO STAND FRAME/TABLE SYSTEM, ANY SIZE INCLUDING PEDIATRIC, WITH SEAT LIFT FEATURE, WITH OR WITHOUT WHEELSRR  DME$209.04

E0637COMBINATION SIT TO STAND FRAME/TABLE SYSTEM, ANY SIZE INCLUDING PEDIATRIC, WITH SEAT LIFT FEATURE, WITH OR WITHOUT WHEELSUE  DME$1,567.67

E0638STANDING FRAME/TABLE SYSTEM, ONE POSITION (E.G., UPRIGHT, SUPINE OR PRONE STANDER), ANY SIZE INCLUDING PEDIATRIC, WITH OR WITHOUT WHEELS    DME$847.60

E0638STANDING FRAME/TABLE SYSTEM, ONE POSITION (E.G., UPRIGHT, SUPINE OR PRONE STANDER), ANY SIZE INCLUDING PEDIATRIC, WITH OR WITHOUT WHEELSRR  DME$84.76

E0638STANDING FRAME/TABLE SYSTEM, ONE POSITION (E.G., UPRIGHT, SUPINE OR PRONE STANDER), ANY SIZE INCLUDING PEDIATRIC, WITH OR WITHOUT WHEELSUE  DME$635.70

E0650PNEUMATIC COMPRESSOR, NON-SEGMENTAL HOME MODELNU  DME$796.20

E0650PNEUMATIC COMPRESSOR, NON-SEGMENTAL HOME MODELRR  DME$95.79

E0650PNEUMATIC COMPRESSOR, NON-SEGMENTAL HOME MODELUE  DME$597.15

E0651PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITHOUT CALIBRATED GRADIENT PRESSURENU  DME$1,002.86

E0651PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITHOUT CALIBRATED GRADIENT PRESSURERR  DME$100.28

E0651PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITHOUT CALIBRATED GRADIENT PRESSUREUE  DME$752.16

E0652PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITH CALIBRATED GRADIENT PRESSURENU  DME$5,860.79

E0652PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITH CALIBRATED GRADIENT PRESSURERR  DME$579.22

E0652PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITH CALIBRATED GRADIENT PRESSUREUE  DME$4,391.67

E0655NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF ARMNU  DME$119.32

E0655NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF ARMRR  DME$14.20

E0655NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF ARMUE  DME$89.60

E0660NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEGNU  DME$176.50

E0660NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEGRR  DME$18.38

E0660NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEGUE  DME$132.38

E0665NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARMNU  DME$151.45

E0665NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARMRR  DME$15.55

E0665NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARMUE  DME$113.60

E0666NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEGNU  DME$152.67

E0666NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEGRR  DME$15.73

E0666NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEGUE  DME$114.52

E0667SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEGNU  DME$357.93

E0667SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEGRR  DME$40.42

E0667SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEGUE  DME$268.45

E0668SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARMNU  DME$488.50

E0668SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARMRR  DME$48.21

E0668SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARMUE  DME$366.39

E0669SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEGNU  DME$202.66

L3500  ORTHOPEDIC SHOE ADDITION, INSOLE, LEATHER    DME  $27.21

L3510  ORTHOPEDIC SHOE ADDITION, INSOLE, RUBBER    DME$27.21

L3520  ORTHOPEDIC SHOE ADDITION, INSOLE, FELT COVERED WITH LEATHER    DME$29.55

L3530   ORTHOPEDIC SHOE ADDITION, SOLE, HALF    DME$29.55

L3540  ORTHOPEDIC SHOE ADDITION, SOLE, FULL    DME$47.36

L3550  ORTHOPEDIC SHOE ADDITION, TOE TAP STANDARD    DME$8.26

L3560  ORTHOPEDIC SHOE ADDITION, TOE TAP, HORSESHOE    DME$21.32

L3570  ORTHOPEDIC SHOE ADDITION, SPECIAL EXTENSION TO INSTEP (LEATHER WITH EYELETS)    DME$79.31

L3580  ORTHOPEDIC SHOE ADDITION, CONVERT INSTEP TO VELCRO CLOSURE    DME$60.35

L3590  ORTHOPEDIC SHOE ADDITION, CONVERT FIRM SHOE COUNTER TO SOFT COUNTER    DME$49.70

L3595  ORTHOPEDIC SHOE ADDITION, MARCH BAR    DME$39.04

L3600   TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, CALIPER PLATE, EXISTING    DME$71.01

L3610   TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, CALIPER PLATE, NEW    DME$93.48

L3620    TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, SOLID STIRRUP, EXISTING    DME$71.01

L3630  TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, SOLID STIRRUP, NEW    DME$93.48

L3640  TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, DENNIS BROWNE SPLINT (RIVETON), BOTH SHOES    DME$40.23

L3649  ORTHOPEDIC SHOE, MODIFICATION, ADDITION OR TRANSFER, NOT OTHERWISE SPECIFIED    DME$0.00

L3650  SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, OFF-THE-SHELF    DME$68.98

L3660  SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND WEBBING, PREFABRICATED, OFF-THE-SHELF    DME  $106.11

L3670  SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), PREFABRICATED, OFF-THE-SHELF    DME$131.52

L3671SHOULDER ORTHOSIS, SHOULDER JOINT DESIGN, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT    DME   $763.06

DISPOSABLE INCONTINENCE PRODUCT

T4521ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, SMALL, EACH    DME  $0.56

T4522ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, MEDIUM, EACH    DME  $0.60

T4523ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, LARGE, EACH    DME  $0.80

T4524ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, EXTRA LARGE, EACH    DME  $0.96

T4525ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, SMALL SIZE, EACH    DME$0.83

T4526ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, MEDIUM SIZE, EACH    DME$0.83

T4527ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, LARGE SIZE, EACH    DME$0.87

T4528ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, EXTRA LARGE SIZE, EACH    DME$1.00

T4529PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, SMALL/MEDIUM SIZE, EACH    DME$0.43

T4530PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, LARGE SIZE, EACH    DME$0.47

T4531PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, SMALL/MEDIUM SIZE, EACH    DME$0.54

​

Insurance Participation

DME Supply based on offering the durable medical equipment (DME) to include but not limited to patient care aids, sleep therapy, oxygen, and other respiratory products at discounted prices due to high deductibles, coinsurance, no insurance, and sometimes simply needed extras not covered by insurance. Therefore DME s. Please see How to Bill Your Health Insurance Guide by DME. 

 DME Supply  Medicare and Medicaid we will be happy to assist and get you enrolled so you do not have to pay the full amount.

DISPOSABLE INCONTINENCE PRODUCT

T4521ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, SMALL, EACH    DME$0.56

T4522ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, MEDIUM, EACH    DME$0.60

T4523ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, LARGE, EACH    DME$0.80

T4524ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, EXTRA LARGE, EACH    DME$0.96

T4525ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, SMALL SIZE, EACH    DME$0.83

T4526ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, MEDIUM SIZE, EACH    DME$0.83

T4527ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, LARGE SIZE, EACH    DME$0.87

T4528ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, EXTRA LARGE SIZE, EACH    DME$1.00

T4529PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, SMALL/MEDIUM SIZE, EACH    DME$0.43

T4530PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, LARGE SIZE, EACH    DME$0.47

T4531PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, SMALL/MEDIUM SIZE, EACH    DME$0.54

T4532PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, LARGE SIZE, EACH    DME$0.54

T4533YOUTH SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, EACH    DME$0.56

T4534YOUTH SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, EACH    DME$0.79

T4535DISPOSABLE LINER/SHIELD/GUARD/PAD/UNDERGARMENT, FOR INCONTINENCE, EACH    DME$0.37

T4541INCONTINENCE PRODUCT, DISPOSABLE UNDERPAD, LARGE, EACH    DME$0.41

T4542INCONTINENCE PRODUCT, DISPOSABLE UNDERPAD, SMALL SIZE, EACH    DME$0.41

T4543ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE BRIEF/DIAPER, ABOVE EXTRA LARGE, EACH    DME$1.95

T4544ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, ABOVE EXTRA LARGE, EACH    DME$1.47

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The Complete HSA Eligibility List

Here it is - the most-comprehensive eligibility list available on the web. From A to Z, items and services deemed eligible for tax-free spending with your Flexible Spending Account (FSA), Health Savings Account (HSA), Health Reimbursement Arrangement (HRA) and more will be here, complete with details and requirements. (Important Reminder: FSAs, HRAs and other account types listed may not all be the same - be sure to check with your administrator to confirm if something is eligible before making a purchase).

We Have these items and more
Baby and wheelchair codes 

​

Email us with any questions concerns
    service@tribalenterprisesllc.com

T4532 PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, LARGE SIZE, EACH    DME $0.54

T4533 YOUTH SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, EACH    DME$0.56

T4534 YOUTH SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, EACH    DME$0.79

T4535 DISPOSABLE LINER/SHIELD/GUARD/PAD/UNDERGARMENT, FOR INCONTINENCE, EACH    DME$0.37

T454 1INCONTINENCE PRODUCT, DISPOSABLE UNDERPAD, LARGE, EACH    DME$0.41

T4542 INCONTINENCE PRODUCT, DISPOSABLE UNDERPAD, SMALL SIZE, EACH    DME$0.41

T4543 ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE BRIEF/DIAPER, ABOVE EXTRA LARGE, EACH    DME$1.95

T4544 ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL-ON, ABOVE EXTRA LARGE, EACH    DME$1.47

 

K0001 STANDARD WHEELCHAIR    DME $404.30

K0001 STANDARD WHEELCHAIRRR  DME $40.43

K0002STANDARD HEMI (LOW SEAT) WHEELCHAIR    DME $667.10

K0002STANDARD HEMI (LOW SEAT) WHEELCHAIRRR  DME$66.71

K0003 LIGHTWEIGHT WHEELCHAIR    DME$608.00

K0003 LIGHTWEIGHT WHEELCHAIRRR  DME$60.80

K0004 HIGH STRENGTH, LIGHTWEIGHT WHEELCHAIR    DME $941.70

K0004 HIGH STRENGTH, LIGHTWEIGHT WHEELCHAIRRR  DME$94.17

K0005 ULTRALIGHTWEIGHT WHEELCHAIRNU  DME$2,009.63

K0005 ULTRALIGHTWEIGHT WHEELCHAIRRR  DME$200.96

K0005ULTRALIGHTWEIGHT WHEELCHAIRUE  DME$1,507.24

K0006HEAVY DUTY WHEELCHAIR    DME$1,017.00

K0006HEAVY DUTY WHEELCHAIRRR  DME$101.70

K0007EXTRA HEAVY DUTY WHEELCHAIR    DME$1,388.30

K0007EXTRA HEAVY DUTY WHEELCHAIRRR  DME$138.83

K0009OTHER MANUAL WHEELCHAIR/BASE    DME$795.60

K0009OTHER MANUAL WHEELCHAIR/BASERR  DME$79.56

K0010STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR    DME$4,709.30

K0010STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIRRR  DME$470.93

K0011STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR WITH PROGRAMMABLE CONTROL PARAMETERS FOR SPEED ADJUSTMENT, TREMOR DAMPENING, ACCELERATION CONTROL AND BRAKING    DME$5,565.90

K0011STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR WITH PROGRAMMABLE CONTROL PARAMETERS FOR SPEED ADJUSTMENT, TREMOR DAMPENING, ACCELERATION CONTROL AND BRAKINGRR  DME$556.59

K0012LIGHTWEIGHT PORTABLE MOTORIZED/POWER WHEELCHAIR    DME$3,414.30

K0012LIGHTWEIGHT PORTABLE MOTORIZED/POWER WHEELCHAIRRR  DME$341.43

 

K0800 POWER OPERATED VEHICLE, GROUP 1 STANDARD, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS NU  DME $1,012.28

K0800POWER OPERATED VEHICLE, GROUP 1 STANDARD, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$101.24

K0800POWER OPERATED VEHICLE, GROUP 1 STANDARD, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSUE  DME$759.21

K0801POWER OPERATED VEHICLE, GROUP 1 HEAVY DUTY, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDSNU  DME$1,700.31

K0801POWER OPERATED VEHICLE, GROUP 1 HEAVY DUTY, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDSRR  DME$170.02

K0801POWER OPERATED VEHICLE, GROUP 1 HEAVY DUTY, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDSUE  DME$1,275.23

K0802POWER OPERATED VEHICLE, GROUP 1 VERY HEAVY DUTY, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDSNU  DME$2,058.04

K0802POWER OPERATED VEHICLE, GROUP 1 VERY HEAVY DUTY, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDSRR  DME$205.80

K0802POWER OPERATED VEHICLE, GROUP 1 VERY HEAVY DUTY, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDSUE  DME$1,543.53

K0815POWER WHEELCHAIR, GROUP 1 STANDARD, SLING/SOLID SEAT AND BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$3,772.40

K0815POWER WHEELCHAIR, GROUP 1 STANDARD, SLING/SOLID SEAT AND BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$377.24

K0816POWER WHEELCHAIR, GROUP 1 STANDARD, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$3,749.10

K0816POWER WHEELCHAIR, GROUP 1 STANDARD, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$374.91

K0822POWER WHEELCHAIR, GROUP 2 STANDARD, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$4,246.20

K0822POWER WHEELCHAIR, GROUP 2 STANDARD, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$424.62

K0823POWER WHEELCHAIR, GROUP 2 STANDARD, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$4,232.70

K0823POWER WHEELCHAIR, GROUP 2 STANDARD, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$423.27

K0824POWER WHEELCHAIR, GROUP 2 HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDS    DME$5,592.70

K0824POWER WHEELCHAIR, GROUP 2 HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDSRR  DME$559.27

K0825POWER WHEELCHAIR, GROUP 2 HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDS    DME$5,149.90

K0825POWER WHEELCHAIR, GROUP 2 HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDSRR  DME$514.99

K0826POWER WHEELCHAIR, GROUP 2 VERY HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDS    DME$7,967.30

K0826POWER WHEELCHAIR, GROUP 2 VERY HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDSRR  DME$796.73

K0827POWER WHEELCHAIR, GROUP 2 VERY HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDS    DME$6,841.60

K0827POWER WHEELCHAIR, GROUP 2 VERY HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDSRR  DME$684.16

K0828POWER WHEELCHAIR, GROUP 2 EXTRA HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORE    DME$9,048.30

K0828POWER WHEELCHAIR, GROUP 2 EXTRA HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORERR  DME$904.83

K0829POWER WHEELCHAIR, GROUP 2 EXTRA HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT 601 POUNDS OR MORE    DME$8,428.40

K0829POWER WHEELCHAIR, GROUP 2 EXTRA HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT 601 POUNDS OR MORERR  DME$842.84

K0835POWER WHEELCHAIR, GROUP 2 STANDARD, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$4,561.10

K0835POWER WHEELCHAIR, GROUP 2 STANDARD, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$456.11

K0841POWER WHEELCHAIR, GROUP 2 STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$4,958.80

K0841POWER WHEELCHAIR, GROUP 2 STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$495.88

K0843POWER WHEELCHAIR, GROUP 2 HEAVY DUTY, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDS    DME$5,935.40

K0843POWER WHEELCHAIR, GROUP 2 HEAVY DUTY, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDSRR  DME$593.54

K0848POWER WHEELCHAIR, GROUP 3 STANDARD, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$7,552.80

K0848POWER WHEELCHAIR, GROUP 3 STANDARD, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$755.28

K0849POWER WHEELCHAIR, GROUP 3 STANDARD, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$7,261.60

K0849POWER WHEELCHAIR, GROUP 3 STANDARD, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$726.16

K0850POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDS    DME$8,761.00

K0850POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDSRR  DME$876.10

K0851POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDS    DME$8,423.70

K0851POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDSRR  DME$842.37

K0852POWER WHEELCHAIR, GROUP 3 VERY HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDS    DME$10,122.70

K0852POWER WHEELCHAIR, GROUP 3 VERY HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDSRR  DME$1,012.27

K0853POWER WHEELCHAIR, GROUP 3 VERY HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDS    DME$10,398.60

K0853POWER WHEELCHAIR, GROUP 3 VERY HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDSRR  DME$1,039.86

K0854POWER WHEELCHAIR, GROUP 3 EXTRA HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORE    DME$13,775.90

K0854POWER WHEELCHAIR, GROUP 3 EXTRA HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORERR  DME$1,377.59

K0855POWER WHEELCHAIR, GROUP 3 EXTRA HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORE    DME$13,013.40

K0855POWER WHEELCHAIR, GROUP 3 EXTRA HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORERR  DME$1,301.34

K0856POWER WHEELCHAIR, GROUP 3 STANDARD, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$8,107.10

K0856POWER WHEELCHAIR, GROUP 3 STANDARD, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$810.71

K0857POWER WHEELCHAIR, GROUP 3 STANDARD, SINGLE POWER OPTION, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$8,269.60

K0857POWER WHEELCHAIR, GROUP 3 STANDARD, SINGLE POWER OPTION, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$826.96

K0858POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT 301 TO 450 POUNDS    DME$10,058.60

K0858POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT 301 TO 450 POUNDSRR  DME$1,005.86

K0859POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, SINGLE POWER OPTION, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDS    DME$9,592.80

K0859POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, SINGLE POWER OPTION, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDSRR  DME$959.28

K0860POWER WHEELCHAIR, GROUP 3 VERY HEAVY DUTY, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDS    DME$14,369.90

K0860POWER WHEELCHAIR, GROUP 3 VERY HEAVY DUTY, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDSRR  DME$1,436.99

K0861POWER WHEELCHAIR, GROUP 3 STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS    DME$8,121.00

K0861POWER WHEELCHAIR, GROUP 3 STANDARD, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSRR  DME$812.10

K0862POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDS    DME$10,058.60

K0862POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDSRR  DME$1,005.86

K0863POWER WHEELCHAIR, GROUP 3 VERY HEAVY DUTY, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDS    DME$14,369.90

K0863POWER WHEELCHAIR, GROUP 3 VERY HEAVY DUTY, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDSRR  DME$1,436.99

K0864POWER WHEELCHAIR, GROUP 3 EXTRA HEAVY DUTY, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORE    DME$17,100.30

K0864POWER WHEELCHAIR, GROUP 3 EXTRA HEAVY DUTY, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORERR  DME$1,710.03

K0890POWER WHEELCHAIR, GROUP 5 PEDIATRIC, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 125 POUNDS    DME$9,133.12

K0890POWER WHEELCHAIR, GROUP 5 PEDIATRIC, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 125 POUNDSRR  DME$913.31

K0891POWER WHEELCHAIR, GROUP 5 PEDIATRIC, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 125 POUNDS    DME$12,095.14

K0891POWER WHEELCHAIR, GROUP 5 PEDIATRIC, MULTIPLE POWER OPTION, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 125 POUNDSRR  DME$1,209.51

L0112 CRANIAL CERVICAL ORTHOSIS, CONGENITAL TORTICOLLIS TYPE, WITH OR WITHOUT SOFT INTERFACE MATERIAL, ADJUSTABLE RANGE OF MOTION JOINT, CUSTOM FABRICATED    DME$1,302.31

L0113 CRANIAL CERVICAL ORTHOSIS, TORTICOLLIS TYPE, WITH OR WITHOUT JOINT, WITH OR WITHOUT SOFT INTERFACE MATERIAL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT    DME $265.34

L0120 CERVICAL, FLEXIBLE, NON-AD

​

Name Details

*Hair ColorantsHair colorants are not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Hair Regrowth or RemovalHair regrowth or removal is not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Hair RemovalHair removal is not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Hair Removal and TransplantsHair removal and transplants are not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Half Way HouseThe cost of a half way house necessary for treatment of an addiction or other medical treatment may be eligible with a Letter of Medical Necessity (LMN) with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Half way house reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Hand Lotion Containing a MedicineHand lotion containing a medicine may be eligible with a Letter of Medical Necessity (LMN) with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Hand lotion containing a medicine is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Hand Sanitizer to Prevent COVID-19Hand sanitizer is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) and health reimbursement arrangement (HRA). Hand sanitizer reimbursement is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Hand Sanitizing Wipes to Prevent COVID-19Hand sanitizing wipes are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Hand sanitizing wipes reimbursement is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Handicap, Disability License PlatesHandicap and disability license plates are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Handicap and disability license plates are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Headache MedicationsHeadache medications are eligible over-the-counter (OTC) products with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Headache medications reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Health Club Dues and FeesHealth club dues are not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Health Institute FeesHealth institute fees may be eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or health reimbursement arrangement (HRA), provided that the fees are for qualified medical services incurred and that the service is prescribed or recommended. You may need to submit a Letter of Medical Necessity in order for the expense to qualify. Health institute fees are not eligible for reimbursement with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Health Insurance PremiumsHealth insurance premiums are not eligible on an FSA, but may be eligible with a health reimbursement arrangement (HRA) and are eligible on a health savings account (HSA) unless already paid for with pre-tax dollars. Health insurance premiums reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Health ScreeningsHealth screenings are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Dental or vision-related screenings are eligible with a limited-purpose flexible spending account (LPFSA). Health screenings are not eligible with a dependent care flexible spending account (DCFSA).

 

*Hearing Aid BatteriesHearing aid batteries are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) and health reimbursement arrangement (HRA). Hearing aid batteries are not eligible for reimbursement with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Hearing AidsHearing aids are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) and health reimbursement arrangement (HRA). Hearing aid reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Heart Rate MonitorHeart rate monitor reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) and health reimbursement arrangement (HRA). Heart rate monitor reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Heart ScanA heart scan is a medical procedure and is therefore eligible for reimbursement with flexible spending accounts (FSA), health savings accounts (HSA) and health reimbursement arrangements (HRA). Heart scans are not eligible for reimbursement with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Heated Neck RestA heated neck rest is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). A heated neck rest is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Heating PadsA heating pad is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). A heating pad is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Hemorrhoid TreatmentHemorrhoid treatment is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Hemorrhoid treatment is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

​

*Herbal MedicationHerbal medication with a Letter of Medical Necessity (LMN) is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Herbal medication is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*HerbsHerbs with a Letter of Medical Necessity (LMN) are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Herbs are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

​

*HMO (Health Maintenance Organization)Insurance premiums are never eligible for reimbursement with a flexible spending account (FSA), but may be eligible with a health reimbursement arrangement (HRA) and are eligible on a health savings account (HSA) unless already paid for with pre-tax dollars. Health insurance premiums reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

​

*Holistic HealersHolistic healers are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Holistic he

alers reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

​

*Home DefibrillatorA home defibrillator is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) and health reimbursement arrangement (HRA). A home defibrillator is not eligible for reimbursement with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Home Diagnostic Kits, Tests, DevicesHome diagnostic kits, tests, devices are typically eligible if used to determine the presence of a disease or dysfunction in the body (e.g. heart attack, stroke, diabetes, cancer, COVID-19). Home diagnostic kits, tests, devices reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Home diagnostic kits, tests, devices reimbursement is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Home Health CareHome Health Care is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Home Health Care is not eligible for reimbursement with a limited-purpose flexible spending account (LPFSA) or a dependent care flexib

le spending account (DCFSA).

 

*Home ImprovementsHome improvements with a Letter of Medical Necessity (LMN) are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Home improvements are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Homeopathic MedicineHomeopathic medicine is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Homeopathic medicine is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Hormone Replacement TherapyHormone replacement therapy is eligible with a prescription for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Hormone replacement therapy is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Hospital CareHospital care is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Hospital care is not eligible with a dependent care flexible spending account (DCFSA), or a limited-purpose flexible spending account (LPFSA).

 

*Hospital Insurance PremiumsHospital insurance premiums, if they have not been paid for with pre-tax dollars, are eligible for reimbursement with a health savings account (HSA) or a health reimbursement arrangement (HRA). Hospital insurance premiums are not eligible with a dependent care flexible spending account (DCFSA), flexible spending account (FSA), or a limited-purpose flexible spending account (LPFSA).

 

*Hospital Services and FeesHospital services and fees are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Hospital services and fees are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Hot and Cold CompressHot and cold compresses are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Hot and cold compresses are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Hot PacksHot packs are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Hot packs are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Hot TubHot tubs are not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA) dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). In very rare cases, a TPA may deem a hot tub as eligible with a Letter of Medical Necessity (LMN) which details that the only reason for purchasing this device is to treat a specific medical condition.

 

*Household HelpGeneral household help is not eligible. Nursing services are eligible if services are for medical care. Reimbursement can cover room and board if medically necessary. Services can occur in the individual's home or another facility. The caregiver does not need to be a registered nurse as long as services are typically provided by nurses. Therefore, in the vast majority of cases, household help reimbursement is not covered by a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*HousekeeperA housekeeper is not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*Human Growth Hormone (HGH)Human Growth Hormone (HGH) is eligible with a prescription for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). HGH is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Human GuideTo assist a physically, visually, hearing or mentally impaired person, the cost of a human guide is a qualified medical expense with a flexible spending account (FSA), health savings account (HSA) and a health reimbursement arrangement (HRA). Human guide reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*HumidifierHumidifiers are eligible for reimbursement with a Letter of Medical Necessity (LMN) for flexible spending accounts (FSA), health savings accounts (HSA), and health reimbursement accounts (HRA). They are not eligible for reimbursement with dependent care flexible spending accounts and limited-purpose flexible spending accounts (LPFSA).

 

*HydrocortisoneHydrocortisone is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Hydrocortisone is not eligible for reimbursement with a limited-purpose flexible spending account (LPFSA) or dependent care flexible spending account (DCFSA).

 

*Hydrogen PeroxideHydrogen peroxide may be eligible with a Letter of Medical Necessity (LMN) with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Hydrogen peroxide reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

 

*HydrotherapyHydrotherapy with a Letter of Medical Necessity (LMN) is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Hydrotherapy is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Hyperbaric Oxygen TherapyHyperbaric therapy with a Letter of Medical Necessity (LMN) is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Hyperbaric therapy is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*Hyperbaric TreatmentsHyperbaric treatments are eligible with a Letter of Medical Necessity for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Hyperbaric treatments are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*HypnosisHypnosis with a Letter of Medical Necessity (LMN) is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Hypnosis is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA).

 

*HysterectomyA hysterectomy is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). A hysterectomy is not eligible with a dependent care flexible spending account (DCFSA), or a limited-purpose flexible spending account (LPFS

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