| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
7,645 |
7,508 |
$453K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,092 |
5,008 |
$406K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,508 |
3,472 |
$296K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,168 |
2,159 |
$137K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,406 |
1,397 |
$110K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
316 |
303 |
$36K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
259 |
257 |
$24K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
19 |
19 |
$15K |
| A4927 |
Gloves, non-sterile, per 100 |
293 |
282 |
$2K |
| 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 |
13 |
13 |
$1K |
| S9999 |
Sales tax |
118 |
97 |
$1K |