| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
6,738 |
6,642 |
$644K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,863 |
5,775 |
$457K |
| T4541 |
Incontinence product, disposable underpad, large, each |
9,616 |
9,496 |
$395K |
| A4927 |
Gloves, non-sterile, per 100 |
24,149 |
23,915 |
$394K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
7,523 |
7,445 |
$361K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,741 |
3,683 |
$358K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
8,005 |
7,374 |
$324K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
2,039 |
1,989 |
$289K |
| A4335 |
Incontinence supply; miscellaneous |
7,964 |
7,814 |
$229K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,351 |
1,328 |
$104K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,172 |
1,154 |
$94K |
| S9999 |
Sales tax |
5,955 |
5,667 |
$69K |
| K0001 |
Standard wheelchair |
1,707 |
1,678 |
$29K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,486 |
1,475 |
$28K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
251 |
239 |
$21K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
161 |
157 |
$11K |
| E0627 |
Seat lift mechanism, electric, any type |
15 |
15 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
101 |
99 |
$3K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
26 |
24 |
$3K |
| E0272 |
Mattress, foam rubber |
351 |
348 |
$3K |
| E0271 |
Mattress, innerspring |
517 |
506 |
$3K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
33 |
24 |
$1K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$1K |
| K0006 |
Heavy duty wheelchair |
12 |
12 |
$530.46 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
38 |
36 |
$333.25 |
| E0156 |
Seat attachment, walker |
13 |
13 |
$117.80 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
12 |
12 |
$111.10 |