| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
1,660 |
1,449 |
$1.24M |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
3,701 |
2,764 |
$579K |
| L0635 |
Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment |
824 |
736 |
$521K |
| L0651 |
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf |
737 |
419 |
$317K |
| L0488 |
Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, prefabricated, includes fitting and adjustment |
293 |
287 |
$185K |
| 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 |
199 |
158 |
$97K |
| L7362 |
Battery charger, six volt, each |
531 |
465 |
$74K |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
160 |
79 |
$27K |
| E0650 |
Pneumatic compressor, non-segmental home model |
398 |
123 |
$15K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
315 |
265 |
$9K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
647 |
550 |
$6K |
| E0731 |
Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric) |
625 |
491 |
$6K |
| A4557 |
Lead wires, (e.g., apnea monitor), per pair |
667 |
530 |
$5K |
| A4287 |
Disposable collection and storage bag for breast milk, any size, any type, each |
343 |
341 |
$4K |
| K1005 |
Disposable collection and storage bag for breast milk, any size, any type, each |
732 |
337 |
$4K |
| E0676 |
Intermittent limb compression device (includes all accessories), not otherwise specified |
23 |
13 |
$3K |
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
369 |
177 |
$2K |
| E0667 |
Segmental pneumatic appliance for use with pneumatic compressor, full leg |
41 |
13 |
$1K |
| E0660 |
Non-segmental pneumatic appliance for use with pneumatic compressor, full leg |
186 |
44 |
$828.91 |
| E0745 |
Neuromuscular stimulator, electronic shock unit |
21 |
12 |
$712.93 |
| A4285 |
Polycarbonate bottle for use with breast pump, replacement |
149 |
117 |
$98.82 |
| A4630 |
Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient |
28 |
15 |
$18.07 |
| A4558 |
Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz |
82 |
28 |
$16.22 |
| A4245 |
Alcohol wipes, per box |
25 |
15 |
$0.88 |
| A4284 |
Breast shield and splash protector for use with breast pump, replacement |
150 |
118 |
$0.00 |
| A4282 |
Adapter for breast pump, replacement |
150 |
118 |
$0.00 |
| A4283 |
Cap for breast pump bottle, replacement |
150 |
118 |
$0.00 |
| A4286 |
Locking ring for breast pump, replacement |
150 |
118 |
$0.00 |
| A4281 |
Tubing for breast pump, replacement |
150 |
118 |
$0.00 |