| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4670 |
Automatic blood pressure monitor |
6,677 |
6,241 |
$333K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,050 |
892 |
$109K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,132 |
1,052 |
$106K |
| E0570 |
Nebulizer, with compressor |
2,033 |
1,950 |
$98K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,995 |
1,783 |
$79K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
823 |
733 |
$71K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
795 |
591 |
$66K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,181 |
1,111 |
$41K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
636 |
588 |
$37K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
588 |
537 |
$35K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
630 |
566 |
$26K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
974 |
920 |
$23K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
207 |
192 |
$19K |
| A4927 |
Gloves, non-sterile, per 100 |
1,091 |
970 |
$16K |
| L0628 |
Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
264 |
248 |
$13K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
85 |
83 |
$7K |
| E0156 |
Seat attachment, walker |
419 |
393 |
$6K |
| E0245 |
Tub stool or bench |
75 |
69 |
$5K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
69 |
65 |
$5K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
43 |
40 |
$4K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
246 |
234 |
$3K |
| A4259 |
Lancets, per box of 100 |
422 |
391 |
$3K |
| E0605 |
Vaporizer, room type |
99 |
96 |
$2K |
| E0607 |
Home blood glucose monitor |
28 |
28 |
$1K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
13 |
12 |
$940.50 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
32 |
32 |
$576.00 |