| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
55,539 |
55,345 |
$2.42M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
19,931 |
19,861 |
$2.04M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
8,514 |
8,493 |
$1.95M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
52,814 |
52,652 |
$1.93M |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
45,257 |
45,129 |
$1.33M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
14,590 |
14,547 |
$1.10M |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
13,686 |
7,118 |
$864K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
24,477 |
24,419 |
$837K |
| L3217 |
Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
9,090 |
4,814 |
$755K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
7,159 |
7,143 |
$376K |
| L3222 |
Orthopedic footwear, mens shoe, hightop, depth inlay, each |
3,412 |
1,803 |
$331K |
| A4927 |
Gloves, non-sterile, per 100 |
56,310 |
56,143 |
$257K |
| L3001 |
Foot, insert, removable, molded to patient model, spenco, each |
1,823 |
1,116 |
$246K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
13,551 |
13,517 |
$242K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
2,913 |
1,587 |
$118K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
67 |
67 |
$111K |
| A6540 |
Gradient compression stocking, waist length, 30-40 mmhg, each |
525 |
498 |
$89K |
| L3410 |
Metatarsal bar wedge, between sole |
1,125 |
671 |
$86K |
| A4670 |
Automatic blood pressure monitor |
962 |
959 |
$47K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
865 |
864 |
$37K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
618 |
354 |
$28K |
| L3485 |
Heel, pad, removable for spur |
545 |
371 |
$26K |
| L3340 |
Heel wedge, sach |
518 |
272 |
$25K |
| 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 |
1,082 |
574 |
$19K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
33 |
33 |
$17K |
| L3002 |
Foot, insert, removable, molded to patient model, plastazote or equal, each |
85 |
71 |
$16K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
782 |
400 |
$16K |
| 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 |
988 |
524 |
$13K |
| L3390 |
Outflare wedge |
184 |
141 |
$10K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
52 |
49 |
$4K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
37 |
37 |
$4K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
53 |
29 |
$1K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
31 |
31 |
$1K |
| K0001 |
Standard wheelchair |
238 |
238 |
$998.68 |
| A4335 |
Incontinence supply; miscellaneous |
150 |
150 |
$912.20 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
252 |
252 |
$308.40 |
| A4660 |
Sphygmomanometer/blood pressure apparatus with cuff and stethoscope |
12 |
12 |
$246.08 |
| L0627 |
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 item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
39 |
39 |
$238.80 |
| 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 |
68 |
36 |
$0.00 |