| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,233 |
4,192 |
$681K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,149 |
2,104 |
$496K |
| A4554 |
Disposable underpads, all sizes |
12,842 |
12,691 |
$475K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,823 |
2,777 |
$360K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,739 |
3,721 |
$166K |
| A4335 |
Incontinence supply; miscellaneous |
12,995 |
12,837 |
$70K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
214 |
213 |
$61K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
12,476 |
12,336 |
$61K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
39 |
37 |
$6K |
| 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 |
234 |
117 |
$450.94 |
| 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 |
72 |
37 |
$0.00 |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
67 |
34 |
$0.00 |