| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
19,514 |
19,384 |
$1.15M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
10,813 |
10,767 |
$1.02M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
10,283 |
10,228 |
$740K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
6,812 |
6,767 |
$718K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
3,217 |
3,211 |
$685K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
13,385 |
13,336 |
$442K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
8,762 |
8,673 |
$287K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
2,784 |
2,762 |
$202K |
| A4927 |
Gloves, non-sterile, per 100 |
18,243 |
18,175 |
$83K |
| K0001 |
Standard wheelchair |
1,397 |
1,381 |
$46K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
513 |
513 |
$28K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
263 |
260 |
$15K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
811 |
789 |
$10K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
51 |
50 |
$2K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
28 |
28 |
$2K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
12 |
12 |
$1K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
54 |
54 |
$699.49 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
67 |
67 |
$149.08 |