| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
25,151 |
25,098 |
$2.60M |
| T4541 |
Incontinence product, disposable underpad, large, each |
39,648 |
39,573 |
$2.55M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
40,825 |
40,746 |
$1.97M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
10,711 |
10,688 |
$1.37M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,484 |
4,481 |
$436K |
| A4927 |
Gloves, non-sterile, per 100 |
29,557 |
29,471 |
$373K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
891 |
889 |
$57K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
123 |
123 |
$11K |
| 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 |
274 |
274 |
$9K |
| 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 |
275 |
275 |
$9K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
53 |
53 |
$6K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
216 |
216 |
$827.24 |
| A4259 |
Lancets, per box of 100 |
175 |
175 |
$58.57 |