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Wholesale Medical Supplies *Plus
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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
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