| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
2,817 |
2,735 |
$1.37M |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
1,495 |
1,438 |
$633K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
2,018 |
1,957 |
$393K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,253 |
2,793 |
$216K |
| E0580 |
Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter |
1,513 |
1,283 |
$158K |
| A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
1,400 |
1,149 |
$148K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
457 |
449 |
$106K |
| T5999 |
Supply, not otherwise specified |
1,878 |
1,825 |
$95K |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
145 |
135 |
$88K |
| L3923 |
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
985 |
886 |
$86K |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
794 |
726 |
$79K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
108 |
106 |
$78K |
| A6444 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard |
742 |
614 |
$66K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,224 |
1,183 |
$62K |
| A4670 |
Automatic blood pressure monitor |
1,420 |
1,343 |
$59K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,541 |
2,407 |
$59K |
| A6260 |
Wound cleansers, any type, any size |
379 |
369 |
$48K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
140 |
139 |
$40K |
| A4927 |
Gloves, non-sterile, per 100 |
2,049 |
2,000 |
$38K |
| A4217 |
Sterile water/saline, 500 ml |
370 |
328 |
$24K |
| A4554 |
Disposable underpads, all sizes |
482 |
480 |
$20K |
| S8186 |
Swivel adapter |
2,645 |
2,527 |
$19K |
| L1270 |
Addition to tlso, (low profile), abdominal pad |
252 |
206 |
$18K |
| E0144 |
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat |
73 |
61 |
$14K |
| A4615 |
Cannula, nasal |
3,305 |
2,713 |
$14K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
498 |
458 |
$14K |
| A4430 |
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each |
41 |
40 |
$14K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
808 |
684 |
$12K |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
342 |
324 |
$11K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
527 |
464 |
$10K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
125 |
125 |
$9K |
| A7030 |
Full face mask used with positive airway pressure device, each |
117 |
93 |
$9K |
| A4616 |
Tubing (oxygen), per foot |
3,161 |
2,717 |
$8K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
138 |
138 |
$8K |
| E0601 |
Continuous positive airway pressure (cpap) device |
13 |
13 |
$6K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
13 |
13 |
$5K |
| A7009 |
Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer |
131 |
131 |
$4K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
51 |
51 |
$4K |
| A7031 |
Face mask interface, replacement for full face mask, each |
105 |
64 |
$4K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
36 |
36 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
13 |
13 |
$2K |
| E1399 |
Durable medical equipment, miscellaneous |
263 |
245 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
80 |
80 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
90 |
79 |
$1K |
| A4663 |
Blood pressure cuff only |
82 |
82 |
$897.78 |
| A4456 |
Adhesive remover, wipes, any type, each |
40 |
37 |
$857.32 |
| A7036 |
Chinstrap used with positive airway pressure device |
85 |
74 |
$796.93 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
170 |
146 |
$641.17 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
178 |
164 |
$598.25 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
92 |
78 |
$546.58 |