| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
10,037 |
9,901 |
$573K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,520 |
5,443 |
$294K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
6,741 |
6,653 |
$279K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,621 |
1,610 |
$118K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
557 |
550 |
$33K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
225 |
147 |
$11K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,594 |
1,491 |
$9K |
| E0245 |
Tub stool or bench |
153 |
153 |
$9K |
| A4259 |
Lancets, per box of 100 |
1,512 |
1,413 |
$4K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
341 |
341 |
$3K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12 |
12 |
$1K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
12 |
12 |
$879.90 |
| A4256 |
Normal, low and high calibrator solution / chips |
90 |
81 |
$213.96 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
12 |
12 |
$210.09 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
24 |
24 |
$169.82 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
12 |
12 |
$146.66 |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
228 |
146 |
$132.06 |