| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
4,147 |
2,428 |
$523K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,850 |
2,825 |
$166K |
| E1399 |
Durable medical equipment, miscellaneous |
1,867 |
1,556 |
$146K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,749 |
1,739 |
$145K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,298 |
2,252 |
$142K |
| A4670 |
Automatic blood pressure monitor |
1,266 |
1,266 |
$126K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,536 |
1,529 |
$98K |
| T5999 |
Supply, not otherwise specified |
2,109 |
1,968 |
$85K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
250 |
250 |
$68K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
767 |
767 |
$65K |
| K0001 |
Standard wheelchair |
1,781 |
1,778 |
$50K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,241 |
869 |
$49K |
| A4927 |
Gloves, non-sterile, per 100 |
878 |
846 |
$47K |
| E0570 |
Nebulizer, with compressor |
1,336 |
1,333 |
$33K |
| L2999 |
Lower extremity orthoses, not otherwise specified |
70 |
50 |
$16K |
| 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 |
165 |
156 |
$11K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
258 |
213 |
$3K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
151 |
88 |
$3K |
| 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 |
50 |
50 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
52 |
52 |
$2K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
26 |
26 |
$2K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
12 |
12 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
37 |
37 |
$1K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
15 |
14 |
$1K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
13 |
13 |
$906.54 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
33 |
33 |
$894.07 |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
12 |
12 |
$839.51 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
193 |
193 |
$680.64 |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
26 |
13 |
$310.08 |
| E0156 |
Seat attachment, walker |
12 |
12 |
$145.83 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
28 |
24 |
$136.47 |
| A7015 |
Aerosol mask, used with dme nebulizer |
36 |
36 |
$60.83 |
| E0271 |
Mattress, innerspring |
73 |
73 |
$0.00 |
| E0305 |
Bed side rails, half length |
74 |
74 |
$0.00 |