| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
36,365 |
36,280 |
$1.58M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
14,952 |
14,919 |
$1.35M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
37,373 |
37,283 |
$1.30M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
9,621 |
9,593 |
$936K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
25,530 |
25,457 |
$767K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
14,224 |
14,178 |
$517K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
6,898 |
4,527 |
$511K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
5,700 |
5,689 |
$326K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
3,964 |
3,381 |
$266K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,221 |
1,220 |
$203K |
| L3002 |
Foot, insert, removable, molded to patient model, plastazote or equal, each |
1,824 |
929 |
$200K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
1,712 |
1,504 |
$132K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
6,879 |
6,844 |
$132K |
| A4927 |
Gloves, non-sterile, per 100 |
28,951 |
28,863 |
$132K |
| L3217 |
Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
794 |
490 |
$74K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
753 |
601 |
$28K |
| A4670 |
Automatic blood pressure monitor |
335 |
334 |
$20K |
| L3410 |
Metatarsal bar wedge, between sole |
284 |
169 |
$18K |
| 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 |
327 |
201 |
$8K |
| L3222 |
Orthopedic footwear, mens shoe, hightop, depth inlay, each |
74 |
39 |
$7K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
28 |
28 |
$6K |
| L3340 |
Heel wedge, sach |
115 |
74 |
$6K |
| A6540 |
Gradient compression stocking, waist length, 30-40 mmhg, each |
27 |
27 |
$5K |
| L3219 |
Orthopedic footwear, mens shoe, oxford, each |
29 |
29 |
$5K |
| A4335 |
Incontinence supply; miscellaneous |
418 |
418 |
$5K |
| 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 |
294 |
172 |
$5K |
| L3001 |
Foot, insert, removable, molded to patient model, spenco, each |
30 |
15 |
$3K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
51 |
45 |
$3K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
40 |
40 |
$1K |
| E1399 |
Durable medical equipment, miscellaneous |
206 |
206 |
$1K |
| E0570 |
Nebulizer, with compressor |
15 |
15 |
$1K |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
13 |
13 |
$678.33 |
| A4402 |
Lubricant, per ounce |
44 |
44 |
$286.67 |