| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
8,509 |
8,396 |
$1.18M |
| T4541 |
Incontinence product, disposable underpad, large, each |
15,425 |
15,192 |
$1.07M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,379 |
4,329 |
$765K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,905 |
4,819 |
$660K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
2,206 |
2,166 |
$588K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
7,829 |
7,703 |
$370K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
228 |
196 |
$188K |
| A4927 |
Gloves, non-sterile, per 100 |
6,967 |
6,856 |
$99K |
| A4670 |
Automatic blood pressure monitor |
956 |
938 |
$57K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
360 |
353 |
$36K |
| K0001 |
Standard wheelchair |
1,138 |
1,073 |
$23K |
| E0570 |
Nebulizer, with compressor |
371 |
337 |
$13K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
37 |
37 |
$3K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
14 |
12 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
48 |
44 |
$2K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
12 |
12 |
$456.49 |
| A4332 |
Lubricant, individual sterile packet, each |
36 |
36 |
$389.65 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
27 |
24 |
$384.49 |
| E0156 |
Seat attachment, walker |
34 |
30 |
$305.96 |