| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
4,575 |
4,236 |
$174K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,871 |
1,729 |
$164K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,143 |
2,790 |
$159K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,726 |
1,578 |
$154K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,767 |
1,634 |
$148K |
| A4927 |
Gloves, non-sterile, per 100 |
5,782 |
5,349 |
$44K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
483 |
447 |
$39K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
116 |
95 |
$33K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
142 |
132 |
$18K |
| E1084 |
Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests |
16 |
14 |
$13K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
242 |
224 |
$12K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
247 |
208 |
$10K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
14 |
12 |
$7K |
| E0601 |
Continuous positive airway pressure (cpap) device |
250 |
214 |
$7K |
| A4259 |
Lancets, per box of 100 |
239 |
221 |
$3K |
| E0246 |
Transfer tub rail attachment |
43 |
28 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
59 |
52 |
$2K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
47 |
37 |
$2K |
| E0241 |
Bath tub wall rail, each |
38 |
26 |
$1K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
16 |
14 |
$957.02 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
14 |
13 |
$493.00 |