| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
5,739 |
5,581 |
$557K |
| L0648 |
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 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 |
397 |
367 |
$119K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
383 |
320 |
$92K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,002 |
966 |
$42K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
631 |
597 |
$41K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,835 |
1,791 |
$37K |
| E0245 |
Tub stool or bench |
493 |
479 |
$33K |
| A4554 |
Disposable underpads, all sizes |
887 |
872 |
$33K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
303 |
301 |
$32K |
| A7006 |
Administration set, with small volume filtered pneumatic nebulizer |
3,540 |
3,448 |
$27K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
239 |
236 |
$24K |
| A4670 |
Automatic blood pressure monitor |
844 |
838 |
$22K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
359 |
314 |
$17K |
| K0001 |
Standard wheelchair |
1,064 |
1,048 |
$14K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
476 |
449 |
$13K |
| E0745 |
Neuromuscular stimulator, electronic shock unit |
126 |
100 |
$12K |
| L3040 |
Foot, arch support, removable, premolded, longitudinal, each |
181 |
162 |
$11K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
213 |
193 |
$11K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
158 |
85 |
$8K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
96 |
61 |
$7K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
97 |
86 |
$7K |
| A7015 |
Aerosol mask, used with dme nebulizer |
5,390 |
5,250 |
$6K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
5,386 |
5,247 |
$5K |
| L0174 |
Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf |
64 |
52 |
$5K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
18 |
12 |
$3K |
| 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 |
64 |
47 |
$3K |
| L3222 |
Orthopedic footwear, mens shoe, hightop, depth inlay, each |
28 |
24 |
$3K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
27 |
26 |
$2K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
27 |
25 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
211 |
193 |
$2K |
| 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 |
14 |
14 |
$2K |
| L3675 |
Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf |
14 |
12 |
$971.32 |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
147 |
120 |
$924.92 |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
21 |
13 |
$802.06 |
| 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 |
52 |
26 |
$751.18 |
| A4557 |
Lead wires, (e.g., apnea monitor), per pair |
140 |
114 |
$668.96 |
| 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 |
52 |
26 |
$660.82 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
160 |
153 |
$510.72 |