| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,051 |
1,993 |
$243K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,566 |
3,463 |
$178K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,914 |
2,835 |
$178K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,325 |
1,278 |
$164K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,342 |
1,301 |
$157K |
| A4670 |
Automatic blood pressure monitor |
3,241 |
2,470 |
$139K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,312 |
1,263 |
$72K |
| A4927 |
Gloves, non-sterile, per 100 |
3,067 |
2,977 |
$62K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
243 |
226 |
$24K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
213 |
198 |
$14K |
| E0570 |
Nebulizer, with compressor |
195 |
192 |
$11K |
| A4259 |
Lancets, per box of 100 |
1,133 |
1,103 |
$10K |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
70 |
55 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
16 |
15 |
$1K |
| E0607 |
Home blood glucose monitor |
14 |
14 |
$701.48 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
251 |
248 |
$701.33 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
24 |
24 |
$361.09 |