| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
21,061 |
18,166 |
$1.47M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
8,855 |
8,113 |
$789K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
11,716 |
10,554 |
$611K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
8,170 |
7,496 |
$599K |
| E0601 |
Continuous positive airway pressure (cpap) device |
7,763 |
6,807 |
$543K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
5,106 |
4,836 |
$489K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,532 |
3,975 |
$382K |
| A4215 |
Needle, sterile, any size, each |
9,319 |
9,016 |
$307K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,907 |
2,632 |
$290K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,985 |
2,650 |
$257K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,510 |
4,657 |
$255K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
3,068 |
2,618 |
$254K |
| A4927 |
Gloves, non-sterile, per 100 |
20,813 |
19,191 |
$248K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,861 |
1,734 |
$219K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,892 |
1,752 |
$190K |
| A4259 |
Lancets, per box of 100 |
16,222 |
14,378 |
$176K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,939 |
1,792 |
$167K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,831 |
4,347 |
$165K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
7,851 |
6,930 |
$157K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
5,368 |
4,196 |
$157K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,539 |
2,280 |
$153K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
3,766 |
3,547 |
$152K |
| E0570 |
Nebulizer, with compressor |
7,483 |
5,803 |
$150K |
| K0001 |
Standard wheelchair |
7,626 |
6,195 |
$133K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
514 |
493 |
$117K |
| A7035 |
Headgear used with positive airway pressure device |
4,872 |
4,363 |
$100K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,023 |
945 |
$100K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,710 |
6,909 |
$97K |
| S8490 |
Insulin syringes (100 syringes, any size) |
4,212 |
4,024 |
$92K |
| A4670 |
Automatic blood pressure monitor |
1,781 |
1,637 |
$89K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
916 |
715 |
$89K |
| T4541 |
Incontinence product, disposable underpad, large, each |
4,878 |
4,158 |
$89K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,367 |
1,248 |
$84K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,569 |
1,331 |
$66K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,121 |
968 |
$55K |
| A7037 |
Tubing used with positive airway pressure device |
2,340 |
2,101 |
$50K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,074 |
624 |
$47K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,533 |
1,215 |
$41K |
| A4245 |
Alcohol wipes, per box |
5,767 |
5,619 |
$33K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,877 |
2,359 |
$24K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,226 |
1,980 |
$21K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
126 |
123 |
$16K |
| K0007 |
Extra heavy duty wheelchair |
188 |
142 |
$14K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,730 |
1,553 |
$13K |
| E0607 |
Home blood glucose monitor |
225 |
222 |
$13K |
| K0006 |
Heavy duty wheelchair |
288 |
243 |
$11K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
1,842 |
1,422 |
$10K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,421 |
3,076 |
$9K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,000 |
856 |
$8K |
| E0156 |
Seat attachment, walker |
844 |
702 |
$7K |
| 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) |
66 |
65 |
$7K |
| K0003 |
Lightweight wheelchair |
236 |
213 |
$6K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
157 |
144 |
$5K |
| E0245 |
Tub stool or bench |
33 |
27 |
$2K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
75 |
64 |
$2K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
373 |
305 |
$2K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
54 |
51 |
$969.24 |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
15 |
12 |
$505.47 |
| E1392 |
Portable oxygen concentrator, rental |
12 |
12 |
$365.73 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
15 |
12 |
$275.71 |
| A7015 |
Aerosol mask, used with dme nebulizer |
111 |
105 |
$159.93 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
31 |
25 |
$68.88 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
79 |
44 |
$0.00 |