| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4670 |
Automatic blood pressure monitor |
1,314 |
1,260 |
$73K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,041 |
986 |
$64K |
| K0001 |
Standard wheelchair |
1,215 |
1,161 |
$50K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
413 |
395 |
$44K |
| E0570 |
Nebulizer, with compressor |
476 |
460 |
$40K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
205 |
179 |
$27K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
206 |
175 |
$25K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
173 |
151 |
$21K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
465 |
443 |
$19K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
607 |
584 |
$12K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
171 |
149 |
$11K |
| A5500 |
For 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 |
53 |
52 |
$6K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
27 |
26 |
$5K |
| A5512 |
For 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 |
53 |
52 |
$3K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
16 |
12 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
87 |
85 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
12 |
12 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
601 |
574 |
$1K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
20 |
18 |
$327.70 |
| E0156 |
Seat attachment, walker |
12 |
12 |
$204.50 |