| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
100,560 |
78,197 |
$11.08M |
| E0570 |
Nebulizer, with compressor |
53,366 |
43,337 |
$4.49M |
| A4670 |
Automatic blood pressure monitor |
32,332 |
28,846 |
$2.02M |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
54,518 |
44,902 |
$1.36M |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
21,025 |
18,563 |
$1.34M |
| K1005 |
Disposable collection and storage bag for breast milk, any size, any type, each |
31,573 |
27,667 |
$1.17M |
| A7000 |
Canister, disposable, used with suction pump, each |
54,468 |
44,235 |
$804K |
| L8310 |
Truss, double with standard pads |
6,267 |
5,337 |
$749K |
| A4287 |
Disposable collection and storage bag for breast milk, any size, any type, each |
14,954 |
11,979 |
$517K |
| A7002 |
Tubing, used with suction pump, each |
54,436 |
44,194 |
$343K |
| L0642 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
1,049 |
824 |
$323K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,750 |
2,975 |
$269K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,260 |
1,014 |
$219K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
2,177 |
1,846 |
$142K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,892 |
2,450 |
$141K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
884 |
776 |
$124K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,027 |
797 |
$106K |
| L2630 |
Addition to lower extremity, pelvic control, band and belt, unilateral |
504 |
491 |
$100K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
630 |
549 |
$88K |
| A7015 |
Aerosol mask, used with dme nebulizer |
54,330 |
44,956 |
$82K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
256 |
204 |
$66K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
239 |
184 |
$37K |
| A4284 |
Breast shield and splash protector for use with breast pump, replacement |
5,159 |
5,070 |
$33K |
| A4927 |
Gloves, non-sterile, per 100 |
3,975 |
3,086 |
$31K |
| A4663 |
Blood pressure cuff only |
1,154 |
1,045 |
$18K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
7,292 |
5,253 |
$9K |
| A4402 |
Lubricant, per ounce |
538 |
423 |
$4K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
35 |
26 |
$4K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
33 |
30 |
$4K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
13 |
12 |
$2K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
26 |
26 |
$1K |
| A5120 |
Skin barrier, wipes or swabs, each |
134 |
89 |
$1K |
| L0626 |
Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
16 |
13 |
$1K |
| A4335 |
Incontinence supply; miscellaneous |
327 |
260 |
$383.95 |
| E0602 |
Breast pump, manual, any type |
16 |
12 |
$94.17 |