| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
21,439 |
20,918 |
$730K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,623 |
5,510 |
$684K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
10,915 |
10,675 |
$404K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,914 |
3,856 |
$383K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,539 |
2,491 |
$337K |
| E1399 |
Durable medical equipment, miscellaneous |
222 |
208 |
$156K |
| A4335 |
Incontinence supply; miscellaneous |
25,933 |
25,234 |
$125K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
850 |
835 |
$114K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,140 |
1,082 |
$103K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,311 |
3,269 |
$92K |
| K0003 |
Lightweight wheelchair |
6,780 |
6,731 |
$91K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
639 |
619 |
$66K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
859 |
814 |
$63K |
| K0001 |
Standard wheelchair |
2,081 |
2,057 |
$56K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
219 |
216 |
$45K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
377 |
354 |
$40K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
458 |
449 |
$38K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
251 |
242 |
$31K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
200 |
197 |
$29K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
932 |
922 |
$24K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
949 |
935 |
$19K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
3,845 |
3,814 |
$18K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
537 |
535 |
$10K |
| A4670 |
Automatic blood pressure monitor |
148 |
147 |
$9K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
88 |
88 |
$7K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
193 |
189 |
$6K |
| A4927 |
Gloves, non-sterile, per 100 |
745 |
727 |
$5K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
14 |
12 |
$561.96 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
41 |
41 |
$524.39 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
40 |
25 |
$326.08 |
| E1020 |
Residual limb support system for wheelchair, any type |
24 |
24 |
$233.21 |
| E0570 |
Nebulizer, with compressor |
12 |
12 |
$75.00 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
87 |
86 |
$37.03 |
| E0935 |
Continuous passive motion exercise device for use on knee only |
12 |
12 |
$0.00 |
| E0156 |
Seat attachment, walker |
13 |
12 |
$0.00 |