| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,215 |
2,186 |
$249K |
| A4554 |
Disposable underpads, all sizes |
6,427 |
6,338 |
$219K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,771 |
1,753 |
$184K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,912 |
2,816 |
$108K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
692 |
676 |
$105K |
| A4335 |
Incontinence supply; miscellaneous |
8,279 |
8,130 |
$45K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,101 |
1,100 |
$26K |
| K0001 |
Standard wheelchair |
1,626 |
1,595 |
$15K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
151 |
148 |
$11K |
| K0003 |
Lightweight wheelchair |
652 |
646 |
$8K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
78 |
77 |
$6K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
738 |
732 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
101 |
99 |
$2K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
446 |
442 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
151 |
148 |
$2K |
| A4670 |
Automatic blood pressure monitor |
16 |
14 |
$803.68 |
| A4245 |
Alcohol wipes, per box |
246 |
232 |
$378.27 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
12 |
12 |
$35.22 |