| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
7,301 |
7,270 |
$1.24M |
| A4554 |
Disposable underpads, all sizes |
18,827 |
18,675 |
$668K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,827 |
3,802 |
$543K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,031 |
2,018 |
$426K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,298 |
2,246 |
$342K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
847 |
844 |
$248K |
| A4335 |
Incontinence supply; miscellaneous |
19,004 |
18,824 |
$99K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
979 |
976 |
$37K |
| K0001 |
Standard wheelchair |
2,751 |
2,675 |
$32K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
987 |
971 |
$29K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
945 |
888 |
$26K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
193 |
189 |
$23K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
160 |
153 |
$20K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
152 |
150 |
$19K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
140 |
138 |
$17K |
| E0570 |
Nebulizer, with compressor |
909 |
882 |
$16K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
3,032 |
2,950 |
$14K |
| E0601 |
Continuous positive airway pressure (cpap) device |
192 |
192 |
$12K |
| A4259 |
Lancets, per box of 100 |
665 |
657 |
$6K |
| A4927 |
Gloves, non-sterile, per 100 |
769 |
765 |
$6K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
257 |
257 |
$4K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
67 |
67 |
$2K |
| A4245 |
Alcohol wipes, per box |
973 |
967 |
$1K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
27 |
27 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
13 |
13 |
$112.75 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
30 |
30 |
$43.37 |
| A7015 |
Aerosol mask, used with dme nebulizer |
30 |
30 |
$29.51 |