| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
14,346 |
13,521 |
$839K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,328 |
5,064 |
$541K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
2,348 |
2,203 |
$487K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,933 |
3,737 |
$444K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,535 |
4,270 |
$409K |
| T4541 |
Incontinence product, disposable underpad, large, each |
9,791 |
9,036 |
$389K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
3,543 |
3,425 |
$139K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
3,161 |
3,145 |
$104K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
297 |
273 |
$47K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
542 |
519 |
$34K |
| 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 |
201 |
193 |
$25K |
| A4927 |
Gloves, non-sterile, per 100 |
1,307 |
1,249 |
$24K |
| K0002 |
Standard hemi (low seat) wheelchair |
403 |
403 |
$17K |
| A4335 |
Incontinence supply; miscellaneous |
852 |
817 |
$11K |
| E1399 |
Durable medical equipment, miscellaneous |
173 |
166 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
206 |
205 |
$7K |
| S5165 |
Home modifications; per service |
27 |
27 |
$3K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
12 |
12 |
$642.51 |
| K0001 |
Standard wheelchair |
13 |
12 |
$229.16 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
12 |
12 |
$155.08 |