| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
529 |
508 |
$103K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
504 |
492 |
$64K |
| T4541 |
Incontinence product, disposable underpad, large, each |
518 |
508 |
$49K |
| 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 |
43 |
41 |
$27K |
| E0570 |
Nebulizer, with compressor |
192 |
192 |
$25K |
| E0601 |
Continuous positive airway pressure (cpap) device |
272 |
272 |
$18K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
235 |
225 |
$14K |
| L1844 |
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated |
12 |
12 |
$11K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
68 |
65 |
$7K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
86 |
84 |
$4K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
128 |
128 |
$3K |
| K0001 |
Standard wheelchair |
79 |
76 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
106 |
104 |
$1K |
| L2810 |
Addition to lower extremity orthosis, knee control, condylar pad |
24 |
24 |
$1K |
| E0154 |
Platform attachment, walker, each |
15 |
15 |
$797.13 |
| L2830 |
Addition to lower extremity orthosis, soft interface for molded plastic, above knee section |
12 |
12 |
$631.69 |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
12 |
12 |
$583.91 |
| K0003 |
Lightweight wheelchair |
12 |
12 |
$498.58 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
12 |
12 |
$422.56 |
| L2780 |
Addition to lower extremity orthosis, non-corrosive finish, per bar |
12 |
12 |
$335.52 |
| A7015 |
Aerosol mask, used with dme nebulizer |
139 |
139 |
$228.44 |
| E0156 |
Seat attachment, walker |
15 |
15 |
$147.80 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
60 |
60 |
$55.80 |