| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
1,254 |
1,230 |
$94K |
| K0003 |
Lightweight wheelchair |
689 |
622 |
$51K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
156 |
156 |
$45K |
| L0648 |
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
146 |
104 |
$37K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
169 |
99 |
$22K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
254 |
125 |
$19K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
445 |
423 |
$19K |
| A4554 |
Disposable underpads, all sizes |
666 |
641 |
$18K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
835 |
756 |
$13K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
361 |
151 |
$12K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
50 |
23 |
$11K |
| A4927 |
Gloves, non-sterile, per 100 |
593 |
570 |
$10K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
151 |
118 |
$10K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,219 |
1,199 |
$9K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
113 |
110 |
$7K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
142 |
70 |
$5K |
| L3807 |
Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
33 |
18 |
$4K |
| A6531 |
Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each |
66 |
32 |
$3K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
97 |
85 |
$3K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
165 |
127 |
$3K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
36 |
25 |
$3K |
| A4670 |
Automatic blood pressure monitor |
123 |
117 |
$2K |
| L0180 |
Cervical, multiple post collar, occipital/mandibular supports, adjustable |
19 |
16 |
$2K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
38 |
26 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
30 |
29 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
94 |
44 |
$1K |
| E0245 |
Tub stool or bench |
14 |
14 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,214 |
1,196 |
$1K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
21 |
15 |
$1K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
12 |
12 |
$569.93 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
30 |
27 |
$385.77 |
| E0167 |
Pail or pan for use with commode chair, replacement only |
78 |
65 |
$6.75 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,212 |
1,192 |
$1.56 |