| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
4,615 |
3,473 |
$493K |
| T4541 |
Incontinence product, disposable underpad, large, each |
10,383 |
7,785 |
$454K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,829 |
2,865 |
$420K |
| A4927 |
Gloves, non-sterile, per 100 |
26,545 |
17,346 |
$358K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
6,833 |
4,857 |
$311K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,552 |
1,861 |
$278K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,369 |
1,808 |
$264K |
| A7030 |
Full face mask used with positive airway pressure device, each |
6,856 |
4,927 |
$264K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
10,818 |
8,115 |
$263K |
| E0601 |
Continuous positive airway pressure (cpap) device |
10,093 |
6,689 |
$207K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,554 |
1,816 |
$187K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
10,679 |
7,378 |
$187K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,703 |
1,268 |
$178K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
5,856 |
4,067 |
$144K |
| A7031 |
Face mask interface, replacement for full face mask, each |
6,567 |
4,727 |
$105K |
| E0570 |
Nebulizer, with compressor |
12,227 |
8,630 |
$100K |
| 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 |
6,984 |
5,001 |
$90K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
537 |
395 |
$89K |
| A4670 |
Automatic blood pressure monitor |
2,047 |
1,417 |
$86K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,302 |
852 |
$85K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
1,540 |
977 |
$80K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,011 |
622 |
$77K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
3,655 |
2,462 |
$64K |
| A7035 |
Headgear used with positive airway pressure device |
7,750 |
5,509 |
$64K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
10,734 |
7,086 |
$60K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,089 |
933 |
$44K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
4,850 |
3,621 |
$40K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
1,060 |
674 |
$36K |
| A4322 |
Irrigation syringe, bulb or piston, each |
1,584 |
854 |
$35K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
3,246 |
2,303 |
$31K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,797 |
1,300 |
$26K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
12,457 |
8,856 |
$26K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
950 |
345 |
$23K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,743 |
1,141 |
$20K |
| K0001 |
Standard wheelchair |
4,628 |
3,153 |
$19K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
186 |
126 |
$15K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
1,721 |
1,380 |
$13K |
| A7037 |
Tubing used with positive airway pressure device |
1,576 |
1,309 |
$12K |
| B9998 |
Noc for enteral supplies |
751 |
309 |
$11K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,387 |
1,544 |
$11K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
250 |
120 |
$7K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
667 |
490 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,071 |
1,342 |
$6K |
| A4259 |
Lancets, per box of 100 |
879 |
761 |
$6K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,393 |
994 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
382 |
188 |
$4K |
| E0156 |
Seat attachment, walker |
557 |
337 |
$3K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
2,907 |
1,327 |
$3K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
916 |
624 |
$3K |
| E0245 |
Tub stool or bench |
54 |
44 |
$3K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
26 |
14 |
$3K |
| A4245 |
Alcohol wipes, per box |
901 |
678 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
851 |
551 |
$1K |
| A4554 |
Disposable underpads, all sizes |
60 |
28 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
327 |
213 |
$955.04 |
| E0184 |
Dry pressure mattress |
57 |
41 |
$900.21 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
139 |
94 |
$771.69 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
490 |
397 |
$725.35 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
492 |
177 |
$659.84 |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
12 |
12 |
$593.69 |
| A7015 |
Aerosol mask, used with dme nebulizer |
461 |
386 |
$333.97 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
271 |
112 |
$267.49 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
20 |
14 |
$166.63 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
50 |
41 |
$139.24 |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
25 |
12 |
$101.08 |
| A4258 |
Spring-powered device for lancet, each |
20 |
13 |
$94.56 |
| K0006 |
Heavy duty wheelchair |
24 |
12 |
$91.80 |
| A4402 |
Lubricant, per ounce |
13 |
12 |
$48.81 |