| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,776 |
1,671 |
$170K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,506 |
1,410 |
$160K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,498 |
2,424 |
$126K |
| A4670 |
Automatic blood pressure monitor |
1,700 |
1,631 |
$100K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,522 |
1,462 |
$77K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
909 |
859 |
$74K |
| E0570 |
Nebulizer, with compressor |
1,687 |
1,655 |
$57K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,803 |
1,750 |
$55K |
| A4927 |
Gloves, non-sterile, per 100 |
2,217 |
2,030 |
$37K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
205 |
199 |
$18K |
| A4259 |
Lancets, per box of 100 |
608 |
595 |
$4K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
26 |
25 |
$2K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
31 |
30 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
54 |
52 |
$2K |
| E0245 |
Tub stool or bench |
12 |
12 |
$900.00 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
31 |
28 |
$399.67 |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
12 |
12 |
$240.60 |
| A7015 |
Aerosol mask, used with dme nebulizer |
16 |
16 |
$25.60 |