| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
15,118 |
14,969 |
$1.13M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
22,513 |
22,315 |
$723K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
20,843 |
20,625 |
$646K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
6,210 |
6,153 |
$597K |
| A4553 |
Non-disposable underpads, all sizes |
7,421 |
7,372 |
$263K |
| A4927 |
Gloves, non-sterile, per 100 |
21,040 |
20,077 |
$236K |
| T4541 |
Incontinence product, disposable underpad, large, each |
11,773 |
11,610 |
$195K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
21,333 |
21,159 |
$175K |
| A4554 |
Disposable underpads, all sizes |
4,201 |
4,174 |
$143K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
941 |
928 |
$120K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
2,942 |
988 |
$79K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
920 |
884 |
$76K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
689 |
687 |
$52K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
202 |
199 |
$24K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
38 |
38 |
$11K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
149 |
57 |
$3K |
| K0001 |
Standard wheelchair |
438 |
433 |
$2K |
| A4670 |
Automatic blood pressure monitor |
38 |
38 |
$2K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
40 |
39 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
78 |
70 |
$898.65 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
557 |
550 |
$652.05 |
| 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 |
50 |
24 |
$487.96 |
| 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 |
48 |
23 |
$472.29 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
16 |
16 |
$250.55 |
| E0156 |
Seat attachment, walker |
14 |
14 |
$34.82 |