| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
8,926 |
7,641 |
$426K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,766 |
3,275 |
$375K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,744 |
3,275 |
$362K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,381 |
3,004 |
$357K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,486 |
2,127 |
$269K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,142 |
1,784 |
$228K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,761 |
4,062 |
$215K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,000 |
810 |
$161K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,064 |
1,753 |
$154K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,302 |
1,075 |
$127K |
| A4927 |
Gloves, non-sterile, per 100 |
8,210 |
6,766 |
$124K |
| A4670 |
Automatic blood pressure monitor |
1,762 |
1,362 |
$78K |
| E0570 |
Nebulizer, with compressor |
2,334 |
1,569 |
$38K |
| E0640 |
Patient lift, fixed system, includes all components/accessories |
21 |
21 |
$32K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
880 |
512 |
$12K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
227 |
155 |
$11K |
| K0001 |
Standard wheelchair |
1,612 |
938 |
$9K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
220 |
172 |
$8K |
| E0245 |
Tub stool or bench |
211 |
105 |
$7K |
| E0156 |
Seat attachment, walker |
815 |
460 |
$5K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
15 |
14 |
$1K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
14 |
14 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
178 |
105 |
$699.08 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
908 |
820 |
$156.42 |
| A4554 |
Disposable underpads, all sizes |
369 |
340 |
$118.50 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
18 |
13 |
$107.46 |
| A7006 |
Administration set, with small volume filtered pneumatic nebulizer |
12 |
12 |
$89.21 |