| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
28,281 |
28,021 |
$1.22M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
10,105 |
10,032 |
$812K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,625 |
4,601 |
$495K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,256 |
3,228 |
$220K |
| T4541 |
Incontinence product, disposable underpad, large, each |
5,778 |
5,722 |
$214K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
1,007 |
999 |
$70K |
| 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 |
1,772 |
1,353 |
$28K |
| 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 |
1,907 |
1,355 |
$25K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
1,521 |
1,500 |
$9K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
133 |
132 |
$9K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
101 |
96 |
$9K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
37 |
37 |
$605.72 |