| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,570 |
2,550 |
$470K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,605 |
2,569 |
$378K |
| A4554 |
Disposable underpads, all sizes |
8,578 |
8,463 |
$295K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,841 |
1,827 |
$224K |
| E0570 |
Nebulizer, with compressor |
1,158 |
1,107 |
$77K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,686 |
1,658 |
$52K |
| A4335 |
Incontinence supply; miscellaneous |
8,516 |
8,429 |
$44K |
| K0003 |
Lightweight wheelchair |
2,187 |
2,167 |
$26K |
| E2228 |
Manual wheelchair accessory, wheel braking system and lock, complete, each |
1,252 |
1,226 |
$9K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,863 |
2,807 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
135 |
131 |
$5K |
| K0001 |
Standard wheelchair |
412 |
403 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
859 |
805 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
912 |
860 |
$841.49 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
131 |
127 |
$372.94 |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
13 |
13 |
$358.75 |
| E0316 |
Safety enclosure frame/canopy for use with hospital bed, any type |
24 |
24 |
$356.28 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
13 |
13 |
$348.20 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
41 |
39 |
$263.88 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
13 |
13 |
$155.68 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
171 |
164 |
$112.86 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
24 |
24 |
$5.76 |
| E0156 |
Seat attachment, walker |
41 |
39 |
$0.00 |