| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
9,457 |
9,394 |
$907K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
4,883 |
4,826 |
$536K |
| A4554 |
Disposable underpads, all sizes |
9,506 |
9,379 |
$483K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,852 |
2,812 |
$337K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,903 |
1,875 |
$172K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
4,296 |
4,261 |
$152K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,078 |
1,067 |
$130K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,654 |
2,626 |
$109K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
1,878 |
1,845 |
$57K |
| A4927 |
Gloves, non-sterile, per 100 |
4,508 |
4,485 |
$13K |
| A4402 |
Lubricant, per ounce |
799 |
798 |
$13K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
42 |
42 |
$3K |
| E0570 |
Nebulizer, with compressor |
33 |
33 |
$3K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
132 |
129 |
$2K |
| A4670 |
Automatic blood pressure monitor |
46 |
46 |
$2K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
13 |
12 |
$1K |
| E0241 |
Bath tub wall rail, each |
16 |
16 |
$579.30 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
33 |
33 |
$345.84 |
| A7015 |
Aerosol mask, used with dme nebulizer |
33 |
33 |
$28.38 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
33 |
33 |
$0.00 |