| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
24,529 |
24,409 |
$551K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
9,597 |
9,578 |
$538K |
| A4554 |
Disposable underpads, all sizes |
23,738 |
23,586 |
$485K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
5,127 |
5,002 |
$345K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
2,587 |
2,560 |
$278K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,091 |
4,088 |
$195K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
1,690 |
1,675 |
$120K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
3,301 |
3,230 |
$90K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
715 |
715 |
$82K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
528 |
513 |
$44K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,327 |
1,314 |
$43K |
| A4670 |
Automatic blood pressure monitor |
123 |
123 |
$5K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
109 |
109 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
440 |
431 |
$2K |
| A4259 |
Lancets, per box of 100 |
24 |
24 |
$21.84 |
| A4245 |
Alcohol wipes, per box |
13 |
13 |
$20.85 |