| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,966 |
1,904 |
$258K |
| A4554 |
Disposable underpads, all sizes |
3,506 |
3,385 |
$217K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,978 |
2,904 |
$113K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
3,123 |
3,037 |
$100K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
741 |
718 |
$91K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,022 |
1,948 |
$65K |
| L3410 |
Metatarsal bar wedge, between sole |
682 |
470 |
$39K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
945 |
461 |
$39K |
| L3310 |
Lift, elevation, heel and sole, neoprene, per inch |
397 |
247 |
$23K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
1,308 |
1,250 |
$22K |
| L3217 |
Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
428 |
206 |
$21K |
| L3222 |
Orthopedic footwear, mens shoe, hightop, depth inlay, each |
191 |
93 |
$11K |
| L3340 |
Heel wedge, sach |
205 |
168 |
$10K |
| A4927 |
Gloves, non-sterile, per 100 |
2,059 |
1,988 |
$9K |
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
170 |
84 |
$4K |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
26 |
25 |
$1K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12 |
12 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
26 |
25 |
$392.40 |