| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
916 |
867 |
$152K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,072 |
1,030 |
$142K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
874 |
857 |
$134K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
880 |
843 |
$89K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
687 |
662 |
$83K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
606 |
575 |
$83K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,127 |
1,098 |
$51K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
788 |
758 |
$45K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
793 |
600 |
$29K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
212 |
194 |
$27K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
438 |
397 |
$21K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
245 |
236 |
$13K |
| A4927 |
Gloves, non-sterile, per 100 |
357 |
348 |
$11K |
| K0001 |
Standard wheelchair |
459 |
432 |
$10K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
66 |
64 |
$8K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
31 |
30 |
$6K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
50 |
26 |
$5K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
12 |
12 |
$4K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
12 |
12 |
$4K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
75 |
66 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
190 |
187 |
$935.36 |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
25 |
24 |
$749.88 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
13 |
12 |
$506.02 |