| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
2,786 |
2,604 |
$407K |
| E0604 |
Breast pump, hospital grade, electric (ac and / or dc), any type |
1,301 |
1,256 |
$78K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
824 |
785 |
$65K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,719 |
1,671 |
$61K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,561 |
1,520 |
$59K |
| K0003 |
Lightweight wheelchair |
1,228 |
1,218 |
$53K |
| A4927 |
Gloves, non-sterile, per 100 |
3,477 |
3,385 |
$49K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
554 |
544 |
$47K |
| E0570 |
Nebulizer, with compressor |
1,437 |
1,397 |
$33K |
| T4541 |
Incontinence product, disposable underpad, large, each |
645 |
627 |
$29K |
| K0001 |
Standard wheelchair |
1,352 |
1,333 |
$25K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
549 |
533 |
$20K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
545 |
540 |
$11K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
39 |
37 |
$8K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
557 |
547 |
$7K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
67 |
65 |
$5K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
46 |
40 |
$4K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
150 |
147 |
$3K |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
68 |
68 |
$2K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
171 |
164 |
$1K |
| E0156 |
Seat attachment, walker |
104 |
100 |
$848.38 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
15 |
14 |
$307.38 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
44 |
40 |
$64.15 |
| A4259 |
Lancets, per box of 100 |
13 |
12 |
$43.37 |