| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
558 |
548 |
$132K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
448 |
436 |
$73K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
399 |
388 |
$48K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
585 |
568 |
$40K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
720 |
708 |
$26K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
834 |
820 |
$23K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
371 |
354 |
$16K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
53 |
53 |
$5K |
| L3260 |
Surgical boot/shoe, each |
237 |
215 |
$4K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
15 |
13 |
$2K |
| A4565 |
Slings |
338 |
329 |
$2K |
| E0570 |
Nebulizer, with compressor |
12 |
12 |
$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 |
14 |
12 |
$479.94 |
| A5120 |
Skin barrier, wipes or swabs, each |
40 |
38 |
$224.72 |