| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E2510 |
Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access |
1,686 |
1,593 |
$11.83M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
9,183 |
8,591 |
$1.58M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
6,389 |
6,010 |
$1.43M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
6,773 |
6,431 |
$1.13M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
2,592 |
2,266 |
$1.01M |
| A4554 |
Disposable underpads, all sizes |
18,600 |
16,488 |
$977K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
2,468 |
2,426 |
$896K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
3,734 |
3,375 |
$793K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
3,859 |
3,554 |
$684K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
2,423 |
2,246 |
$643K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
5,295 |
4,908 |
$551K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,321 |
2,173 |
$387K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,198 |
1,132 |
$230K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
387 |
380 |
$218K |
| E2599 |
Accessory for speech generating device, not otherwise classified |
181 |
164 |
$202K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
445 |
328 |
$201K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,127 |
920 |
$174K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
484 |
465 |
$162K |
| E0676 |
Intermittent limb compression device (includes all accessories), not otherwise specified |
144 |
125 |
$149K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
572 |
545 |
$140K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
716 |
625 |
$140K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
355 |
349 |
$99K |
| E1399 |
Durable medical equipment, miscellaneous |
92 |
83 |
$94K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
436 |
390 |
$87K |
| A4927 |
Gloves, non-sterile, per 100 |
8,535 |
7,680 |
$76K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
37 |
37 |
$49K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
906 |
689 |
$43K |
| A6550 |
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories |
374 |
267 |
$35K |
| K0001 |
Standard wheelchair |
417 |
309 |
$29K |
| A4670 |
Automatic blood pressure monitor |
343 |
333 |
$27K |
| 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 |
48 |
45 |
$26K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,355 |
1,175 |
$26K |
| A4553 |
Non-disposable underpads, all sizes |
476 |
461 |
$24K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
114 |
114 |
$24K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
549 |
526 |
$24K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
115 |
113 |
$23K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
155 |
129 |
$22K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
57 |
57 |
$17K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
52 |
51 |
$13K |
| A6260 |
Wound cleansers, any type, any size |
689 |
580 |
$12K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
355 |
321 |
$11K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
840 |
721 |
$10K |
| A4311 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
345 |
310 |
$7K |
| A7000 |
Canister, disposable, used with suction pump, each |
369 |
265 |
$6K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
147 |
127 |
$5K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
110 |
97 |
$5K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
537 |
472 |
$4K |
| E0570 |
Nebulizer, with compressor |
27 |
27 |
$4K |
| E0156 |
Seat attachment, walker |
233 |
222 |
$3K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
14 |
13 |
$3K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
218 |
159 |
$2K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
54 |
48 |
$2K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
118 |
105 |
$2K |
| A4335 |
Incontinence supply; miscellaneous |
385 |
374 |
$2K |
| E0325 |
Urinal; male, jug-type, any material |
209 |
177 |
$1K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
141 |
85 |
$1K |
| A4930 |
Gloves, sterile, per pair |
38 |
37 |
$1K |
| A5120 |
Skin barrier, wipes or swabs, each |
208 |
172 |
$1K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
47 |
45 |
$658.00 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
51 |
24 |
$557.31 |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
65 |
62 |
$546.96 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
263 |
239 |
$379.08 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
28 |
13 |
$181.32 |
| A4452 |
Tape, waterproof, per 18 square inches |
12 |
12 |
$92.07 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
49 |
48 |
$70.96 |