| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
3,628 |
3,608 |
$368K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,908 |
3,895 |
$250K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,806 |
3,789 |
$214K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,107 |
2,093 |
$97K |
| K0001 |
Standard wheelchair |
2,945 |
2,941 |
$83K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
977 |
958 |
$52K |
| E0570 |
Nebulizer, with compressor |
2,030 |
2,027 |
$50K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
541 |
536 |
$38K |
| K0003 |
Lightweight wheelchair |
356 |
355 |
$29K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
97 |
92 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
162 |
161 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
69 |
69 |
$3K |
| 90694 |
|
27 |
27 |
$2K |
| E0245 |
Tub stool or bench |
27 |
26 |
$1K |
| E0271 |
Mattress, innerspring |
43 |
43 |
$1K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
16 |
12 |
$635.55 |
| E0156 |
Seat attachment, walker |
41 |
40 |
$611.68 |