| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,254 |
2,226 |
$257K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,175 |
2,149 |
$223K |
| A4554 |
Disposable underpads, all sizes |
4,122 |
4,064 |
$206K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,362 |
2,333 |
$187K |
| S5185 |
Medication reminder service, non-face-to-face; per month |
487 |
475 |
$128K |
| E0570 |
Nebulizer, with compressor |
2,393 |
2,369 |
$89K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,269 |
1,252 |
$43K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
248 |
247 |
$36K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
918 |
694 |
$34K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
142 |
140 |
$21K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
713 |
703 |
$21K |
| L0625 |
Lumbar orthosis, flexible, provides lumbar support, 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 pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf |
560 |
558 |
$20K |
| L2116 |
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment |
90 |
89 |
$19K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
556 |
298 |
$19K |
| A4670 |
Automatic blood pressure monitor |
232 |
231 |
$11K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
282 |
275 |
$8K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
126 |
124 |
$7K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
104 |
103 |
$5K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
73 |
72 |
$4K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
77 |
77 |
$3K |
| E0156 |
Seat attachment, walker |
125 |
123 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
163 |
158 |
$719.92 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
65 |
64 |
$614.35 |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
12 |
12 |
$580.83 |
| E0240 |
Bath/shower chair, with or without wheels, any size |
15 |
14 |
$483.56 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
40 |
39 |
$467.93 |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
24 |
24 |
$329.77 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
26 |
26 |
$285.04 |
| A5120 |
Skin barrier, wipes or swabs, each |
24 |
24 |
$168.80 |