| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,679 |
1,590 |
$168K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
1,770 |
1,445 |
$145K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,464 |
1,455 |
$131K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,721 |
2,645 |
$118K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,047 |
1,045 |
$115K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,038 |
1,025 |
$94K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
845 |
800 |
$76K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,331 |
1,311 |
$66K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
737 |
642 |
$66K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,609 |
1,531 |
$61K |
| A4670 |
Automatic blood pressure monitor |
1,071 |
1,057 |
$60K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
552 |
532 |
$54K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,302 |
1,269 |
$38K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
353 |
333 |
$28K |
| E0570 |
Nebulizer, with compressor |
388 |
387 |
$22K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
173 |
158 |
$15K |
| A4927 |
Gloves, non-sterile, per 100 |
746 |
730 |
$8K |
| A4259 |
Lancets, per box of 100 |
740 |
723 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
221 |
221 |
$659.97 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
15 |
13 |
$576.34 |
| A7015 |
Aerosol mask, used with dme nebulizer |
202 |
202 |
$322.96 |