| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
20,292 |
20,249 |
$505K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
7,391 |
7,368 |
$459K |
| A4554 |
Disposable underpads, all sizes |
17,531 |
17,489 |
$389K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
3,033 |
2,231 |
$249K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
3,637 |
3,629 |
$210K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
3,081 |
3,075 |
$136K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
4,564 |
4,533 |
$128K |
| L3217 |
Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
733 |
399 |
$60K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,695 |
1,686 |
$53K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
397 |
395 |
$43K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
655 |
637 |
$43K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,165 |
2,148 |
$26K |
| A4215 |
Needle, sterile, any size, each |
555 |
555 |
$20K |
| 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 |
385 |
312 |
$16K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
195 |
177 |
$15K |
| 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 |
295 |
248 |
$9K |
| A4259 |
Lancets, per box of 100 |
1,798 |
1,787 |
$6K |
| A4927 |
Gloves, non-sterile, per 100 |
1,318 |
1,297 |
$5K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
126 |
126 |
$5K |
| E1399 |
Durable medical equipment, miscellaneous |
94 |
94 |
$2K |
| A4245 |
Alcohol wipes, per box |
1,196 |
1,196 |
$1K |
| S8490 |
Insulin syringes (100 syringes, any size) |
93 |
93 |
$1K |
| A4402 |
Lubricant, per ounce |
152 |
152 |
$727.84 |
| A4670 |
Automatic blood pressure monitor |
12 |
12 |
$570.80 |