| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
13,042 |
12,369 |
$722K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
9,530 |
9,019 |
$699K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,532 |
5,190 |
$532K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,692 |
4,510 |
$446K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,338 |
4,166 |
$426K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
2,143 |
1,620 |
$265K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
966 |
828 |
$188K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,882 |
1,763 |
$179K |
| A4927 |
Gloves, non-sterile, per 100 |
19,904 |
18,776 |
$130K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,113 |
3,117 |
$124K |
| E0245 |
Tub stool or bench |
201 |
175 |
$66K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,076 |
928 |
$64K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,300 |
1,595 |
$58K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,148 |
1,539 |
$55K |
| E0246 |
Transfer tub rail attachment |
951 |
611 |
$54K |
| E0241 |
Bath tub wall rail, each |
966 |
849 |
$35K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
299 |
211 |
$26K |
| K0001 |
Standard wheelchair |
2,608 |
1,860 |
$17K |
| E0940 |
Trapeze bar, free standing, complete with grab bar |
2,004 |
1,439 |
$15K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
133 |
130 |
$12K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
123 |
79 |
$12K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
341 |
113 |
$10K |
| A4259 |
Lancets, per box of 100 |
777 |
685 |
$10K |
| 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 |
299 |
111 |
$8K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
169 |
142 |
$7K |
| E0570 |
Nebulizer, with compressor |
799 |
538 |
$6K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
898 |
632 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
86 |
65 |
$4K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
53 |
49 |
$4K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
29 |
24 |
$4K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
166 |
144 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
560 |
448 |
$4K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
305 |
218 |
$3K |
| A4256 |
Normal, low and high calibrator solution / chips |
445 |
402 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
130 |
102 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
14 |
13 |
$1K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
19 |
13 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
15 |
13 |
$798.33 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
62 |
37 |
$703.11 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
357 |
214 |
$605.40 |
| E0156 |
Seat attachment, walker |
168 |
105 |
$588.95 |
| E0305 |
Bed side rails, half length |
201 |
108 |
$282.25 |
| A7037 |
Tubing used with positive airway pressure device |
14 |
13 |
$132.24 |
| A7035 |
Headgear used with positive airway pressure device |
53 |
39 |
$126.98 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
39 |
25 |
$125.75 |
| Z2077 |
|
19 |
16 |
$0.00 |