| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
1,782 |
1,769 |
$68K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,126 |
1,064 |
$61K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
333 |
332 |
$46K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
392 |
391 |
$46K |
| A4335 |
Incontinence supply; miscellaneous |
2,656 |
2,653 |
$15K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
653 |
652 |
$4K |
| K0003 |
Lightweight wheelchair |
181 |
179 |
$2K |
| A4256 |
Normal, low and high calibrator solution / chips |
384 |
383 |
$364.36 |
| A4259 |
Lancets, per box of 100 |
652 |
651 |
$297.53 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$202.76 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
127 |
125 |
$202.72 |
| E0607 |
Home blood glucose monitor |
17 |
16 |
$76.93 |
| A4258 |
Spring-powered device for lancet, each |
51 |
51 |
$25.26 |