| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
266 |
252 |
$10K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
227 |
172 |
$8K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
101 |
98 |
$8K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
213 |
151 |
$8K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
106 |
98 |
$6K |
| A4670 |
Automatic blood pressure monitor |
125 |
121 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
268 |
258 |
$4K |
| L0627 |
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 item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
30 |
30 |
$4K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
45 |
37 |
$3K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
71 |
60 |
$3K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
47 |
27 |
$3K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
69 |
60 |
$2K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
90 |
71 |
$2K |
| E0570 |
Nebulizer, with compressor |
23 |
17 |
$1K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
72 |
47 |
$1K |
| 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 |
12 |
12 |
$564.69 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
47 |
46 |
$387.35 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
50 |
40 |
$259.62 |