| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0240 |
Bath/shower chair, with or without wheels, any size |
6,112 |
4,671 |
$1.70M |
| A4554 |
Disposable underpads, all sizes |
29,745 |
26,675 |
$1.26M |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
1,743 |
1,423 |
$1.22M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
13,075 |
11,782 |
$1.06M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
17,204 |
15,445 |
$1.06M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
11,487 |
10,258 |
$784K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
9,584 |
8,638 |
$710K |
| A4927 |
Gloves, non-sterile, per 100 |
30,987 |
27,280 |
$336K |
| E0246 |
Transfer tub rail attachment |
6,410 |
2,785 |
$322K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
4,484 |
4,100 |
$309K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
4,153 |
2,716 |
$275K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,360 |
1,274 |
$152K |
| L0631 |
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 item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
245 |
168 |
$147K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,434 |
2,045 |
$126K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
3,999 |
3,502 |
$124K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
2,413 |
2,211 |
$123K |
| K0011 |
Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking |
23 |
13 |
$93K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,035 |
2,661 |
$91K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
2,570 |
1,793 |
$87K |
| L0637 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
92 |
85 |
$81K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
1,295 |
926 |
$64K |
| E0241 |
Bath tub wall rail, each |
2,632 |
1,890 |
$55K |
| L3916 |
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
189 |
148 |
$50K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
414 |
267 |
$50K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,515 |
3,048 |
$49K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
477 |
370 |
$45K |
| A4259 |
Lancets, per box of 100 |
4,243 |
2,705 |
$43K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
464 |
363 |
$41K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
588 |
510 |
$38K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
581 |
493 |
$31K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
320 |
266 |
$31K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
286 |
197 |
$31K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
889 |
717 |
$31K |
| E0607 |
Home blood glucose monitor |
594 |
373 |
$29K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
459 |
406 |
$28K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
151 |
127 |
$28K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
83 |
56 |
$27K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
644 |
582 |
$23K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
194 |
129 |
$21K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
349 |
314 |
$19K |
| B9002 |
Enteral nutrition infusion pump, any type |
692 |
452 |
$19K |
| K0001 |
Standard wheelchair |
2,645 |
2,458 |
$18K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
979 |
870 |
$16K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
202 |
180 |
$12K |
| K0003 |
Lightweight wheelchair |
1,161 |
1,049 |
$9K |
| E0935 |
Continuous passive motion exercise device for use on knee only |
52 |
50 |
$7K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
52 |
39 |
$5K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
62 |
51 |
$5K |
| B9998 |
Noc for enteral supplies |
313 |
246 |
$5K |
| E0156 |
Seat attachment, walker |
607 |
504 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
3,011 |
2,718 |
$4K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
158 |
109 |
$4K |
| E0430 |
Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
165 |
112 |
$4K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
93 |
65 |
$4K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
120 |
95 |
$4K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
179 |
169 |
$3K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
18 |
13 |
$2K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
19 |
17 |
$1K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
73 |
66 |
$943.10 |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
74 |
67 |
$839.19 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
104 |
101 |
$321.22 |
| E0570 |
Nebulizer, with compressor |
127 |
124 |
$250.92 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
289 |
224 |
$249.15 |