| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
10,486 |
10,269 |
$491K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
3,955 |
3,894 |
$363K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,587 |
2,519 |
$246K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
7,112 |
7,081 |
$233K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,990 |
2,925 |
$204K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
3,381 |
3,246 |
$103K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
1,446 |
730 |
$91K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
2,413 |
2,375 |
$71K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
232 |
232 |
$50K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
136 |
67 |
$30K |
| A4927 |
Gloves, non-sterile, per 100 |
4,765 |
4,598 |
$21K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
370 |
185 |
$16K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
885 |
800 |
$12K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
246 |
114 |
$12K |
| E1399 |
Durable medical equipment, miscellaneous |
1,519 |
1,518 |
$10K |
| L3215 |
Orthopedic footwear, ladies shoe, oxford, each |
86 |
60 |
$8K |
| A4335 |
Incontinence supply; miscellaneous |
602 |
602 |
$4K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
33 |
17 |
$4K |
| A4402 |
Lubricant, per ounce |
464 |
447 |
$2K |
| L3217 |
Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
26 |
12 |
$2K |
| A4670 |
Automatic blood pressure monitor |
12 |
12 |
$585.00 |