| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
15,498 |
15,496 |
$969K |
| A4554 |
Disposable underpads, all sizes |
30,674 |
30,670 |
$834K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
10,032 |
10,027 |
$769K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
23,046 |
23,039 |
$601K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
9,235 |
5,059 |
$490K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
4,837 |
2,731 |
$187K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
3,542 |
3,542 |
$167K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
4,851 |
4,849 |
$127K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
2,170 |
1,145 |
$85K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
551 |
551 |
$61K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,605 |
1,604 |
$42K |
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
1,720 |
864 |
$39K |
| A4927 |
Gloves, non-sterile, per 100 |
1,897 |
1,897 |
$8K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
54 |
54 |
$5K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
129 |
80 |
$4K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
63 |
63 |
$772.23 |
| A5120 |
Skin barrier, wipes or swabs, each |
56 |
56 |
$729.00 |