| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,389 |
2,126 |
$360K |
| A4554 |
Disposable underpads, all sizes |
4,323 |
3,815 |
$242K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
326 |
286 |
$71K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
476 |
418 |
$65K |
| A4927 |
Gloves, non-sterile, per 100 |
2,094 |
1,902 |
$56K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
249 |
188 |
$54K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
232 |
205 |
$31K |
| A5120 |
Skin barrier, wipes or swabs, each |
2,476 |
2,227 |
$21K |
| A4930 |
Gloves, sterile, per pair |
66 |
49 |
$17K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
316 |
254 |
$8K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
14 |
13 |
$2K |
| E1639 |
Scale, each |
14 |
13 |
$1K |
| 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 |
18 |
12 |
$898.14 |
| A4670 |
Automatic blood pressure monitor |
14 |
13 |
$859.69 |
| A4928 |
Surgical mask, per 20 |
15 |
15 |
$255.15 |