| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
49,786 |
49,574 |
$7.25M |
| A4554 |
Disposable underpads, all sizes |
81,006 |
79,627 |
$5.57M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
22,879 |
22,454 |
$2.51M |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
76,007 |
74,686 |
$2.30M |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
65,366 |
64,241 |
$1.90M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
15,078 |
14,888 |
$1.79M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
19,037 |
18,676 |
$1.65M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
31,700 |
31,141 |
$1.09M |
| L0642 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
4,745 |
4,703 |
$993K |
| L2630 |
Addition to lower extremity, pelvic control, band and belt, unilateral |
5,383 |
5,335 |
$963K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
54,497 |
53,368 |
$922K |
| A4287 |
Disposable collection and storage bag for breast milk, any size, any type, each |
10,364 |
10,260 |
$428K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
4,720 |
4,711 |
$316K |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
5,566 |
5,359 |
$307K |
| A4927 |
Gloves, non-sterile, per 100 |
69,140 |
67,844 |
$280K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
3,332 |
3,325 |
$262K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
1,959 |
1,564 |
$212K |
| A6540 |
Gradient compression stocking, waist length, 30-40 mmhg, each |
1,207 |
1,032 |
$186K |
| A5120 |
Skin barrier, wipes or swabs, each |
19,979 |
19,946 |
$150K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
7,688 |
4,042 |
$149K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
829 |
828 |
$143K |
| L0649 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
804 |
800 |
$116K |
| A4670 |
Automatic blood pressure monitor |
2,317 |
2,293 |
$112K |
| K1005 |
Disposable collection and storage bag for breast milk, any size, any type, each |
1,942 |
1,911 |
$79K |
| A4510 |
Surgical stockings full length, each |
547 |
293 |
$40K |
| T4541 |
Incontinence product, disposable underpad, large, each |
710 |
710 |
$34K |
| A4402 |
Lubricant, per ounce |
3,767 |
3,740 |
$33K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
335 |
335 |
$22K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
328 |
328 |
$20K |
| E0570 |
Nebulizer, with compressor |
170 |
170 |
$13K |
| K0001 |
Standard wheelchair |
459 |
456 |
$11K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
99 |
99 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
486 |
482 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
183 |
183 |
$2K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
12 |
12 |
$918.99 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
12 |
12 |
$344.44 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
24 |
24 |
$309.85 |
| E0156 |
Seat attachment, walker |
24 |
24 |
$305.84 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
12 |
12 |
$147.98 |
| A7015 |
Aerosol mask, used with dme nebulizer |
183 |
183 |
$131.35 |