| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
127,712 |
114,692 |
$22.39M |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
24,520 |
22,234 |
$2.02M |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
17,439 |
16,675 |
$1.81M |
| 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 |
36,015 |
31,911 |
$1.75M |
| K1005 |
Disposable collection and storage bag for breast milk, any size, any type, each |
17,034 |
15,404 |
$1.17M |
| A4287 |
Disposable collection and storage bag for breast milk, any size, any type, each |
13,876 |
13,058 |
$1.14M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
23,199 |
20,828 |
$1.12M |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
12,747 |
11,931 |
$1.06M |
| L2630 |
Addition to lower extremity, pelvic control, band and belt, unilateral |
7,651 |
7,161 |
$1.02M |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
2,590 |
1,742 |
$884K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
9,923 |
8,868 |
$704K |
| T4541 |
Incontinence product, disposable underpad, large, each |
21,385 |
18,183 |
$694K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
4,210 |
4,032 |
$581K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
8,558 |
7,573 |
$569K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
6,893 |
6,283 |
$559K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
5,480 |
4,763 |
$509K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
5,869 |
5,629 |
$458K |
| A4467 |
Belt, strap, sleeve, garment, or covering, any type |
6,505 |
6,154 |
$380K |
| A4554 |
Disposable underpads, all sizes |
14,314 |
13,555 |
$322K |
| L0641 |
Lumbar orthosis, sagittal control, with rigid posterior panel(s), 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, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
5,128 |
4,923 |
$240K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
2,714 |
2,529 |
$236K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
2,656 |
1,950 |
$216K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,819 |
1,689 |
$131K |
| E0570 |
Nebulizer, with compressor |
14,670 |
13,426 |
$122K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,666 |
1,141 |
$100K |
| A6245 |
Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
3,754 |
3,606 |
$99K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,709 |
4,291 |
$79K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
878 |
830 |
$78K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,373 |
1,704 |
$71K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
488 |
347 |
$45K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,732 |
2,071 |
$42K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,175 |
1,712 |
$39K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,640 |
1,246 |
$36K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,633 |
1,849 |
$34K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,678 |
1,399 |
$28K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,151 |
2,006 |
$24K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,353 |
1,004 |
$22K |
| A4927 |
Gloves, non-sterile, per 100 |
1,800 |
1,776 |
$22K |
| A7035 |
Headgear used with positive airway pressure device |
2,586 |
1,968 |
$19K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
590 |
417 |
$18K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
224 |
199 |
$14K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
157 |
130 |
$10K |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
87 |
83 |
$10K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,888 |
3,603 |
$9K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
95 |
78 |
$8K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
104 |
92 |
$8K |
| A7045 |
Exhalation port with or without swivel used with accessories for positive airway devices, replacement only |
2,360 |
1,789 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,003 |
1,455 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
1,384 |
996 |
$7K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,031 |
743 |
$5K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
126 |
113 |
$5K |
| A4332 |
Lubricant, individual sterile packet, each |
790 |
593 |
$5K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
39 |
37 |
$3K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
86 |
63 |
$3K |
| A4285 |
Polycarbonate bottle for use with breast pump, replacement |
280 |
257 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
66 |
52 |
$2K |
| A4284 |
Breast shield and splash protector for use with breast pump, replacement |
523 |
278 |
$2K |
| A4281 |
Tubing for breast pump, replacement |
520 |
277 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,583 |
1,537 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
97 |
64 |
$1K |
| A4283 |
Cap for breast pump bottle, replacement |
310 |
278 |
$1K |
| A4282 |
Adapter for breast pump, replacement |
520 |
277 |
$885.00 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
2,082 |
1,979 |
$881.63 |
| A6550 |
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories |
76 |
40 |
$675.96 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
232 |
207 |
$629.29 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
246 |
176 |
$619.59 |
| A7036 |
Chinstrap used with positive airway pressure device |
126 |
91 |
$568.95 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
47 |
24 |
$531.02 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
17 |
13 |
$353.85 |
| 94660 |
|
13 |
12 |
$299.95 |
| A4286 |
Locking ring for breast pump, replacement |
513 |
276 |
$173.00 |
| A7000 |
Canister, disposable, used with suction pump, each |
73 |
37 |
$140.07 |
| A4617 |
Mouth piece |
152 |
149 |
$70.64 |
| E1353 |
Regulator |
38 |
33 |
$11.97 |
| A4322 |
Irrigation syringe, bulb or piston, each |
12 |
12 |
$5.80 |