| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
22,453 |
22,439 |
$1.01M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
20,052 |
20,039 |
$785K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
6,493 |
6,489 |
$402K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
5,085 |
5,079 |
$346K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
6,201 |
6,199 |
$337K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,500 |
1,411 |
$264K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
8,693 |
8,686 |
$136K |
| A4927 |
Gloves, non-sterile, per 100 |
5,840 |
5,838 |
$106K |
| K0001 |
Standard wheelchair |
2,140 |
1,956 |
$89K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
4,683 |
4,680 |
$89K |
| E0601 |
Continuous positive airway pressure (cpap) device |
667 |
665 |
$57K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
854 |
853 |
$57K |
| A4335 |
Incontinence supply; miscellaneous |
3,644 |
3,638 |
$43K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
531 |
531 |
$41K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,106 |
1,105 |
$37K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,369 |
2,102 |
$37K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
2,351 |
2,347 |
$25K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
291 |
290 |
$24K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,901 |
2,543 |
$22K |
| E0604 |
Breast pump, hospital grade, electric (ac and / or dc), any type |
322 |
260 |
$16K |
| E1238 |
Wheelchair, pediatric size, folding, adjustable, without seating system |
64 |
64 |
$9K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
3,019 |
2,661 |
$9K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
130 |
130 |
$5K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
24 |
24 |
$2K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
13 |
13 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
208 |
208 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
70 |
70 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
27 |
27 |
$564.53 |