| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
1,883 |
1,810 |
$1.16M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
2,682 |
961 |
$818K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
1,154 |
1,144 |
$247K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
456 |
447 |
$161K |
| E0986 |
Manual wheelchair accessory, power assist system |
228 |
223 |
$112K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,258 |
1,242 |
$81K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
2,385 |
1,513 |
$78K |
| A4927 |
Gloves, non-sterile, per 100 |
1,789 |
1,693 |
$38K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
718 |
696 |
$35K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
1,311 |
1,286 |
$29K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
345 |
301 |
$21K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
548 |
517 |
$12K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
109 |
109 |
$9K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
95 |
72 |
$7K |
| K0001 |
Standard wheelchair |
26 |
25 |
$6K |
| K0040 |
Adjustable angle footplate, each |
89 |
69 |
$6K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
102 |
91 |
$5K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
71 |
69 |
$4K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
252 |
221 |
$4K |
| A4402 |
Lubricant, per ounce |
1,025 |
1,005 |
$3K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
134 |
133 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
116 |
116 |
$1K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
13 |
13 |
$894.62 |
| A4456 |
Adhesive remover, wipes, any type, each |
40 |
36 |
$354.97 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
18 |
12 |
$198.46 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
13 |
13 |
$196.20 |
| A5112 |
Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each |
14 |
12 |
$167.10 |
| A5120 |
Skin barrier, wipes or swabs, each |
14 |
13 |
$139.11 |