| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
5,524 |
5,331 |
$799K |
| L2630 |
Addition to lower extremity, pelvic control, band and belt, unilateral |
2,628 |
2,606 |
$435K |
| A4554 |
Disposable underpads, all sizes |
4,166 |
3,912 |
$263K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
2,835 |
2,720 |
$206K |
| A4287 |
Disposable collection and storage bag for breast milk, any size, any type, each |
3,679 |
3,651 |
$152K |
| K1005 |
Disposable collection and storage bag for breast milk, any size, any type, each |
3,557 |
3,444 |
$124K |
| L0624 |
Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated |
889 |
886 |
$115K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
4,258 |
4,045 |
$108K |
| A6540 |
Gradient compression stocking, waist length, 30-40 mmhg, each |
760 |
754 |
$101K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
3,224 |
3,044 |
$95K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
670 |
639 |
$60K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
430 |
406 |
$58K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
602 |
559 |
$55K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
613 |
610 |
$50K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
3,213 |
3,033 |
$44K |
| A4927 |
Gloves, non-sterile, per 100 |
4,446 |
4,199 |
$18K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
101 |
97 |
$14K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
347 |
331 |
$12K |
| A6534 |
Gradient compression stocking, thigh length, 30-40 mmhg, each |
228 |
228 |
$8K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
240 |
239 |
$7K |
| 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 |
48 |
48 |
$2K |