| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
13,046 |
12,036 |
$1.83M |
| T4541 |
Incontinence product, disposable underpad, large, each |
37,572 |
34,888 |
$1.80M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
11,059 |
10,327 |
$1.53M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
19,861 |
18,313 |
$1.20M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
4,967 |
4,614 |
$1.18M |
| A4927 |
Gloves, non-sterile, per 100 |
41,287 |
38,214 |
$1.11M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
7,305 |
6,781 |
$1.05M |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
5,365 |
4,501 |
$859K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
5,007 |
4,615 |
$647K |
| A4553 |
Non-disposable underpads, all sizes |
28,911 |
26,616 |
$431K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
5,706 |
5,296 |
$292K |
| A4554 |
Disposable underpads, all sizes |
3,907 |
3,320 |
$183K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,372 |
1,288 |
$161K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
756 |
647 |
$140K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
929 |
869 |
$132K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,171 |
1,104 |
$98K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
801 |
454 |
$82K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,672 |
1,454 |
$61K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
405 |
345 |
$58K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
721 |
545 |
$51K |
| T5999 |
Supply, not otherwise specified |
432 |
350 |
$38K |
| K0001 |
Standard wheelchair |
1,126 |
1,007 |
$37K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,419 |
2,162 |
$27K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
471 |
349 |
$18K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
77 |
75 |
$11K |
| 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 |
426 |
218 |
$9K |
| 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 |
210 |
112 |
$8K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
90 |
77 |
$5K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
136 |
105 |
$4K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
15 |
13 |
$3K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
112 |
105 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
212 |
209 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
53 |
51 |
$1K |