| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
1,950 |
1,886 |
$129K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
935 |
907 |
$99K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
823 |
799 |
$85K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,710 |
1,658 |
$78K |
| A4670 |
Automatic blood pressure monitor |
1,095 |
1,060 |
$67K |
| 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 |
342 |
333 |
$35K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
231 |
212 |
$30K |
| A4927 |
Gloves, non-sterile, per 100 |
766 |
751 |
$8K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
39 |
39 |
$4K |
| E0144 |
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat |
13 |
13 |
$4K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
41 |
39 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
99 |
91 |
$1K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
13 |
13 |
$1K |
| E0570 |
Nebulizer, with compressor |
12 |
12 |
$1K |
| E0156 |
Seat attachment, walker |
41 |
41 |
$758.35 |
| A4452 |
Tape, waterproof, per 18 square inches |
26 |
24 |
$592.89 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
14 |
14 |
$213.22 |