| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
20,676 |
20,230 |
$2.30M |
| A4554 |
Disposable underpads, all sizes |
50,786 |
50,091 |
$2.26M |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
34,508 |
18,263 |
$2.15M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
8,505 |
8,496 |
$1.86M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
38,931 |
38,481 |
$1.16M |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
20,805 |
10,902 |
$946K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
35,195 |
34,576 |
$920K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
11,744 |
11,662 |
$820K |
| L3001 |
Foot, insert, removable, molded to patient model, spenco, each |
7,380 |
4,043 |
$689K |
| L3217 |
Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
8,546 |
4,851 |
$570K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
22,144 |
21,805 |
$570K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
10,544 |
5,489 |
$552K |
| L3222 |
Orthopedic footwear, mens shoe, hightop, depth inlay, each |
3,461 |
1,952 |
$257K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
7,071 |
3,440 |
$251K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,980 |
4,964 |
$245K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
12,746 |
12,490 |
$177K |
| L3410 |
Metatarsal bar wedge, between sole |
2,448 |
1,234 |
$156K |
| A6540 |
Gradient compression stocking, waist length, 30-40 mmhg, each |
793 |
773 |
$131K |
| A4927 |
Gloves, non-sterile, per 100 |
28,445 |
27,968 |
$126K |
| L3485 |
Heel, pad, removable for spur |
1,701 |
933 |
$61K |
| L3340 |
Heel wedge, sach |
833 |
413 |
$38K |
| A4670 |
Automatic blood pressure monitor |
786 |
770 |
$31K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
504 |
504 |
$22K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
186 |
88 |
$20K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
491 |
259 |
$19K |
| A4335 |
Incontinence supply; miscellaneous |
6,379 |
6,354 |
$14K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
233 |
119 |
$11K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
75 |
74 |
$7K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
194 |
192 |
$7K |
| A4402 |
Lubricant, per ounce |
2,173 |
2,168 |
$7K |
| L3050 |
Foot, arch support, removable, premolded, metatarsal, each |
145 |
69 |
$6K |
| L3002 |
Foot, insert, removable, molded to patient model, plastazote or equal, each |
23 |
13 |
$3K |
| A4660 |
Sphygmomanometer/blood pressure apparatus with cuff and stethoscope |
66 |
66 |
$1K |
| E0241 |
Bath tub wall rail, each |
28 |
28 |
$858.01 |