| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
27,899 |
27,589 |
$1.38M |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
17,445 |
17,178 |
$530K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
6,115 |
5,990 |
$485K |
| T4541 |
Incontinence product, disposable underpad, large, each |
19,724 |
19,440 |
$369K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,093 |
4,034 |
$322K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,270 |
4,219 |
$308K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
15,487 |
15,347 |
$297K |
| A4927 |
Gloves, non-sterile, per 100 |
17,985 |
16,964 |
$292K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,490 |
3,447 |
$266K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,906 |
2,868 |
$254K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,104 |
1,073 |
$230K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,646 |
1,629 |
$150K |
| A4553 |
Non-disposable underpads, all sizes |
1,917 |
1,912 |
$69K |
| A4554 |
Disposable underpads, all sizes |
2,180 |
2,174 |
$64K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,865 |
1,804 |
$63K |
| K0004 |
High strength, lightweight wheelchair |
503 |
500 |
$22K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
729 |
717 |
$21K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
240 |
240 |
$20K |
| K0001 |
Standard wheelchair |
1,695 |
1,647 |
$19K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
367 |
209 |
$17K |
| A4335 |
Incontinence supply; miscellaneous |
136 |
126 |
$14K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
67 |
66 |
$11K |
| E0570 |
Nebulizer, with compressor |
945 |
888 |
$11K |
| K0003 |
Lightweight wheelchair |
433 |
430 |
$10K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
277 |
131 |
$9K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
246 |
241 |
$9K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,195 |
2,137 |
$8K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
208 |
205 |
$6K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
47 |
47 |
$3K |
| 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 |
70 |
62 |
$1K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
40 |
39 |
$949.31 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
165 |
162 |
$869.70 |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
12 |
12 |
$761.19 |
| 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 |
70 |
62 |
$407.10 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
26 |
26 |
$396.82 |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
12 |
12 |
$362.62 |
| E0156 |
Seat attachment, walker |
54 |
54 |
$345.93 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
14 |
13 |
$167.56 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
12 |
12 |
$86.30 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
15 |
12 |
$82.96 |