| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
27,777 |
26,214 |
$3.62M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
31,511 |
29,601 |
$1.72M |
| A4554 |
Disposable underpads, all sizes |
28,816 |
27,333 |
$1.58M |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
20,706 |
19,395 |
$1.45M |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
18,800 |
17,780 |
$1.40M |
| A4927 |
Gloves, non-sterile, per 100 |
29,082 |
28,069 |
$737K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
21,776 |
21,369 |
$297K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
2,513 |
2,469 |
$161K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,143 |
1,061 |
$158K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,251 |
1,205 |
$117K |
| A4215 |
Needle, sterile, any size, each |
1,622 |
1,550 |
$71K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
257 |
212 |
$46K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
1,252 |
903 |
$37K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
273 |
270 |
$35K |
| E0190 |
Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories |
145 |
132 |
$34K |
| A4245 |
Alcohol wipes, per box |
3,378 |
3,234 |
$29K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,466 |
2,353 |
$28K |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
3,009 |
2,781 |
$24K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
332 |
256 |
$23K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
74 |
71 |
$15K |
| A4259 |
Lancets, per box of 100 |
2,361 |
2,266 |
$6K |
| A4670 |
Automatic blood pressure monitor |
85 |
77 |
$5K |
| E0607 |
Home blood glucose monitor |
88 |
88 |
$3K |
| S8490 |
Insulin syringes (100 syringes, any size) |
81 |
77 |
$3K |
| 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 |
36 |
18 |
$2K |
| 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 |
79 |
47 |
$1K |
| K0001 |
Standard wheelchair |
104 |
99 |
$1K |
| A4258 |
Spring-powered device for lancet, each |
90 |
89 |
$337.55 |