| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,600 |
2,581 |
$352K |
| A4554 |
Disposable underpads, all sizes |
7,936 |
7,859 |
$285K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,628 |
1,602 |
$242K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,999 |
3,967 |
$171K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,564 |
1,548 |
$164K |
| A4335 |
Incontinence supply; miscellaneous |
8,587 |
8,487 |
$46K |
| E0745 |
Neuromuscular stimulator, electronic shock unit |
529 |
522 |
$9K |
| E0635 |
Patient lift, electric with seat or sling |
168 |
167 |
$4K |
| A4670 |
Automatic blood pressure monitor |
36 |
36 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
452 |
431 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
37 |
37 |
$528.57 |
| A4927 |
Gloves, non-sterile, per 100 |
57 |
57 |
$426.79 |
| K0001 |
Standard wheelchair |
77 |
76 |
$315.90 |
| A4259 |
Lancets, per box of 100 |
392 |
377 |
$114.07 |
| 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 |
218 |
144 |
$44.88 |
| E0570 |
Nebulizer, with compressor |
80 |
79 |
$30.24 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
13 |
12 |
$28.47 |
| A7015 |
Aerosol mask, used with dme nebulizer |
15 |
13 |
$3.08 |
| 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 |
218 |
143 |
$0.00 |