| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,213 |
4,187 |
$464K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,532 |
3,495 |
$319K |
| T4541 |
Incontinence product, disposable underpad, large, each |
5,628 |
5,583 |
$309K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
6,261 |
6,198 |
$268K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,318 |
5,267 |
$258K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,262 |
2,253 |
$244K |
| A4927 |
Gloves, non-sterile, per 100 |
14,535 |
14,243 |
$177K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,242 |
2,214 |
$157K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,443 |
1,432 |
$152K |
| E0570 |
Nebulizer, with compressor |
2,532 |
2,494 |
$125K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,286 |
1,271 |
$105K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
826 |
809 |
$94K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,162 |
1,152 |
$87K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
997 |
986 |
$84K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
994 |
987 |
$75K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
593 |
575 |
$61K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
312 |
311 |
$59K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,216 |
1,200 |
$31K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
162 |
148 |
$30K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
184 |
180 |
$30K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,945 |
1,922 |
$26K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
348 |
346 |
$22K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
454 |
442 |
$20K |
| K0001 |
Standard wheelchair |
773 |
759 |
$20K |
| A7035 |
Headgear used with positive airway pressure device |
813 |
806 |
$18K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
374 |
366 |
$15K |
| A7030 |
Full face mask used with positive airway pressure device, each |
142 |
141 |
$14K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
309 |
304 |
$13K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
139 |
127 |
$10K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,271 |
1,249 |
$7K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
37 |
37 |
$6K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
39 |
39 |
$4K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
28 |
26 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
322 |
318 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
186 |
186 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
377 |
376 |
$3K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
326 |
286 |
$3K |
| E0156 |
Seat attachment, walker |
278 |
269 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
37 |
37 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
971 |
957 |
$2K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
28 |
27 |
$1K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
28 |
25 |
$1K |
| A7000 |
Canister, disposable, used with suction pump, each |
41 |
37 |
$714.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
973 |
950 |
$596.67 |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
26 |
26 |
$474.94 |
| A7002 |
Tubing, used with suction pump, each |
30 |
25 |
$417.34 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
12 |
12 |
$348.02 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
13 |
13 |
$217.37 |