| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,466 |
2,466 |
$307K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,335 |
5,335 |
$281K |
| A4554 |
Disposable underpads, all sizes |
3,619 |
3,614 |
$207K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,199 |
2,199 |
$193K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,137 |
1,137 |
$145K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
486 |
486 |
$42K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
997 |
994 |
$35K |
| L0631 |
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 item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
50 |
50 |
$26K |
| A4402 |
Lubricant, per ounce |
1,945 |
1,942 |
$15K |
| A4927 |
Gloves, non-sterile, per 100 |
3,455 |
3,455 |
$15K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
28 |
14 |
$5K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
75 |
75 |
$3K |
| E0241 |
Bath tub wall rail, each |
41 |
41 |
$1K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
12 |
12 |
$357.90 |
| A4335 |
Incontinence supply; miscellaneous |
4,138 |
4,132 |
$0.00 |