| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,488 |
3,452 |
$108K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,134 |
1,123 |
$87K |
| A4554 |
Disposable underpads, all sizes |
2,465 |
2,447 |
$80K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
698 |
694 |
$59K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
876 |
867 |
$44K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
205 |
200 |
$28K |
| A4927 |
Gloves, non-sterile, per 100 |
2,580 |
2,567 |
$11K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
253 |
249 |
$10K |
| E0241 |
Bath tub wall rail, each |
275 |
275 |
$9K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
322 |
317 |
$9K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
232 |
226 |
$7K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
310 |
308 |
$7K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
117 |
117 |
$4K |
| A4259 |
Lancets, per box of 100 |
252 |
249 |
$3K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
93 |
93 |
$2K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
54 |
53 |
$1K |
| E0243 |
Toilet rail, each |
30 |
30 |
$932.62 |
| K0001 |
Standard wheelchair |
39 |
39 |
$741.13 |
| E0246 |
Transfer tub rail attachment |
14 |
14 |
$673.40 |
| E0244 |
Raised toilet seat |
33 |
33 |
$524.75 |
| A4245 |
Alcohol wipes, per box |
225 |
222 |
$353.15 |
| A4258 |
Spring-powered device for lancet, each |
16 |
16 |
$52.27 |