| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
7,281 |
7,221 |
$526K |
| T4541 |
Incontinence product, disposable underpad, large, each |
8,086 |
8,057 |
$493K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,426 |
2,414 |
$167K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,987 |
1,984 |
$165K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,589 |
2,582 |
$141K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,708 |
1,679 |
$88K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
5,112 |
5,086 |
$84K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
5,810 |
5,791 |
$76K |
| L0639 |
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
367 |
362 |
$74K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
410 |
410 |
$36K |
| A4335 |
Incontinence supply; miscellaneous |
4,863 |
4,844 |
$33K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
330 |
329 |
$26K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
241 |
241 |
$26K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
695 |
692 |
$24K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
218 |
132 |
$22K |
| L1832 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
206 |
123 |
$20K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
435 |
433 |
$18K |
| A4927 |
Gloves, non-sterile, per 100 |
1,063 |
1,059 |
$11K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
113 |
113 |
$8K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
283 |
163 |
$5K |
| L0648 |
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
26 |
26 |
$4K |
| L0637 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
13 |
13 |
$2K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
12 |
12 |
$2K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
32 |
32 |
$1K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
26 |
26 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
30 |
30 |
$377.17 |