| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0575 |
Nebulizer, ultrasonic, large volume |
560 |
479 |
$139K |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
55 |
49 |
$118K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
2,206 |
863 |
$90K |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
1,895 |
1,734 |
$74K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
1,418 |
541 |
$59K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,226 |
524 |
$49K |
| A4554 |
Disposable underpads, all sizes |
2,237 |
1,011 |
$35K |
| E0570 |
Nebulizer, with compressor |
395 |
369 |
$28K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
296 |
132 |
$24K |
| E0784 |
External ambulatory infusion pump, insulin |
21 |
15 |
$22K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
638 |
225 |
$21K |
| L3217 |
Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
469 |
140 |
$18K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,254 |
2,083 |
$17K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
324 |
131 |
$13K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
190 |
116 |
$10K |
| S8100 |
Holding chamber or spacer for use with an inhaler or nebulizer; without mask |
193 |
193 |
$9K |
| L3001 |
Foot, insert, removable, molded to patient model, spenco, each |
128 |
43 |
$6K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
152 |
56 |
$6K |
| 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 |
903 |
317 |
$2K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
24 |
12 |
$2K |
| K0001 |
Standard wheelchair |
165 |
110 |
$2K |
| 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 |
613 |
206 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
12 |
12 |
$142.10 |
| E0156 |
Seat attachment, walker |
12 |
12 |
$43.12 |