| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
4,546 |
4,088 |
$709K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
8,242 |
7,435 |
$565K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,973 |
3,696 |
$262K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,689 |
2,317 |
$260K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,706 |
2,387 |
$259K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,443 |
2,240 |
$257K |
| A4927 |
Gloves, non-sterile, per 100 |
12,949 |
11,285 |
$215K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,975 |
1,735 |
$205K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,486 |
1,394 |
$176K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
1,113 |
923 |
$161K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,408 |
1,297 |
$154K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,322 |
2,684 |
$151K |
| T4541 |
Incontinence product, disposable underpad, large, each |
6,263 |
5,575 |
$132K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,545 |
1,397 |
$131K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,774 |
1,635 |
$124K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,961 |
2,734 |
$117K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,189 |
1,757 |
$115K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,044 |
932 |
$102K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,019 |
843 |
$91K |
| A4215 |
Needle, sterile, any size, each |
2,811 |
2,610 |
$89K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,573 |
4,261 |
$83K |
| A4259 |
Lancets, per box of 100 |
6,229 |
5,648 |
$76K |
| E0607 |
Home blood glucose monitor |
1,526 |
1,389 |
$73K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,145 |
813 |
$67K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
2,169 |
1,875 |
$62K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,496 |
1,102 |
$57K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,195 |
3,775 |
$51K |
| A7035 |
Headgear used with positive airway pressure device |
2,075 |
1,921 |
$48K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,802 |
1,578 |
$48K |
| E0570 |
Nebulizer, with compressor |
3,595 |
3,151 |
$45K |
| K0001 |
Standard wheelchair |
1,906 |
1,549 |
$38K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
212 |
200 |
$37K |
| S8490 |
Insulin syringes (100 syringes, any size) |
1,171 |
1,100 |
$37K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
380 |
314 |
$25K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
847 |
611 |
$21K |
| A4258 |
Spring-powered device for lancet, each |
1,779 |
1,603 |
$21K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,286 |
1,173 |
$15K |
| A4670 |
Automatic blood pressure monitor |
318 |
286 |
$14K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
146 |
141 |
$13K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
149 |
121 |
$10K |
| A4245 |
Alcohol wipes, per box |
2,621 |
2,414 |
$10K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
141 |
121 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
475 |
414 |
$6K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
579 |
540 |
$5K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
34 |
24 |
$5K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
340 |
257 |
$4K |
| A7037 |
Tubing used with positive airway pressure device |
111 |
107 |
$3K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
52 |
37 |
$3K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
14 |
12 |
$3K |
| L3260 |
Surgical boot/shoe, each |
78 |
62 |
$3K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
39 |
38 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
57 |
48 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
27 |
25 |
$378.03 |