| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
3,957 |
3,684 |
$20K |
| K0003 |
Lightweight wheelchair |
1,386 |
1,384 |
$13K |
| E0235 |
Paraffin bath unit, portable (see medical supply code a4265 for paraffin) |
1,303 |
1,301 |
$7K |
| 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 |
2,659 |
1,557 |
$6K |
| 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 |
2,643 |
1,551 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
162 |
162 |
$3K |
| A4259 |
Lancets, per box of 100 |
3,936 |
3,666 |
$2K |
| E0210 |
Electric heat pad, standard |
132 |
132 |
$2K |
| L0642 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 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 |
68 |
68 |
$2K |
| E0156 |
Seat attachment, walker |
111 |
111 |
$777.94 |
| L0641 |
Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
30 |
30 |
$646.37 |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
96 |
93 |
$635.36 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
56 |
56 |
$369.54 |
| E0607 |
Home blood glucose monitor |
12 |
12 |
$99.70 |
| A4258 |
Spring-powered device for lancet, each |
12 |
12 |
$7.10 |
| L4205 |
Repair of orthotic device, labor component, per 15 minutes |
60 |
56 |
$0.00 |
| L4002 |
Replacement strap, any orthosis, includes all components, any length, any type |
60 |
56 |
$0.00 |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
23 |
13 |
$0.00 |