| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
5,835 |
5,657 |
$1.17M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
6,369 |
6,158 |
$855K |
| T4541 |
Incontinence product, disposable underpad, large, each |
6,745 |
6,528 |
$641K |
| E0570 |
Nebulizer, with compressor |
1,317 |
1,290 |
$177K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
458 |
452 |
$33K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,282 |
1,262 |
$28K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
197 |
195 |
$17K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
150 |
147 |
$14K |
| K0001 |
Standard wheelchair |
395 |
391 |
$8K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
542 |
532 |
$5K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
75 |
66 |
$4K |
| E0154 |
Platform attachment, walker, each |
99 |
98 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
75 |
74 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,283 |
1,255 |
$2K |
| E0246 |
Transfer tub rail attachment |
33 |
28 |
$2K |
| E0243 |
Toilet rail, each |
15 |
14 |
$718.30 |
| E0156 |
Seat attachment, walker |
87 |
85 |
$630.87 |
| A4927 |
Gloves, non-sterile, per 100 |
12 |
12 |
$308.99 |