| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
16,739 |
16,586 |
$1.90M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
31,466 |
31,108 |
$1.66M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12,015 |
11,890 |
$1.31M |
| A4927 |
Gloves, non-sterile, per 100 |
40,561 |
40,090 |
$684K |
| T4541 |
Incontinence product, disposable underpad, large, each |
16,459 |
16,264 |
$644K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,235 |
4,189 |
$464K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
5,442 |
5,390 |
$195K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,767 |
1,744 |
$172K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,431 |
1,411 |
$159K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,302 |
1,275 |
$154K |
| A4553 |
Non-disposable underpads, all sizes |
6,738 |
6,658 |
$102K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,148 |
1,137 |
$72K |
| A4245 |
Alcohol wipes, per box |
8,205 |
8,101 |
$67K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
259 |
256 |
$31K |
| A4259 |
Lancets, per box of 100 |
8,008 |
7,657 |
$29K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
626 |
615 |
$10K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
8,312 |
7,944 |
$7K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
67 |
67 |
$5K |
| A4670 |
Automatic blood pressure monitor |
82 |
78 |
$4K |
| K0001 |
Standard wheelchair |
101 |
76 |
$400.67 |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
15 |
15 |
$292.32 |
| E0156 |
Seat attachment, walker |
17 |
17 |
$259.88 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
29 |
29 |
$162.54 |
| E0607 |
Home blood glucose monitor |
14 |
14 |
$30.40 |
| A4335 |
Incontinence supply; miscellaneous |
22 |
22 |
$0.00 |