| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
2,135 |
2,063 |
$132K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
790 |
775 |
$130K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,251 |
2,172 |
$98K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
565 |
553 |
$78K |
| A4927 |
Gloves, non-sterile, per 100 |
2,077 |
1,986 |
$62K |
| A6541 |
Gradient compression stocking, waist length, 40 mmhg or greater, each |
299 |
285 |
$50K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
345 |
328 |
$46K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
132 |
121 |
$31K |
| A4930 |
Gloves, sterile, per pair |
619 |
584 |
$22K |
| 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 |
324 |
232 |
$13K |
| A6534 |
Gradient compression stocking, thigh length, 30-40 mmhg, each |
86 |
83 |
$8K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
106 |
106 |
$4K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
12 |
12 |
$3K |
| 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 |
148 |
82 |
$2K |