| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
31,604 |
31,459 |
$1.14M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
9,614 |
9,566 |
$1.08M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
21,416 |
21,052 |
$834K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
7,496 |
7,473 |
$715K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,043 |
3,026 |
$430K |
| A4335 |
Incontinence supply; miscellaneous |
35,211 |
35,035 |
$191K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,233 |
1,205 |
$165K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
712 |
709 |
$119K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
507 |
506 |
$47K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
48 |
48 |
$8K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
14 |
14 |
$5K |
| A4670 |
Automatic blood pressure monitor |
74 |
74 |
$4K |
| K0003 |
Lightweight wheelchair |
349 |
349 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
181 |
181 |
$3K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
25 |
25 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12 |
12 |
$1K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
223 |
223 |
$516.93 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
22 |
12 |
$480.80 |
| A4259 |
Lancets, per box of 100 |
12 |
12 |
$113.28 |
| A4245 |
Alcohol wipes, per box |
12 |
12 |
$19.20 |
| L0637 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
19 |
19 |
$0.00 |