| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
6,133 |
5,589 |
$790K |
| T4541 |
Incontinence product, disposable underpad, large, each |
11,752 |
10,841 |
$599K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
7,970 |
7,345 |
$450K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,914 |
3,521 |
$426K |
| A4927 |
Gloves, non-sterile, per 100 |
19,512 |
17,793 |
$362K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,514 |
2,326 |
$291K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,380 |
2,183 |
$276K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
861 |
762 |
$155K |
| A4670 |
Automatic blood pressure monitor |
2,550 |
2,216 |
$139K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
662 |
560 |
$117K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
956 |
890 |
$113K |
| E0570 |
Nebulizer, with compressor |
1,379 |
1,266 |
$72K |
| E0245 |
Tub stool or bench |
791 |
707 |
$52K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
883 |
810 |
$49K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,541 |
1,149 |
$45K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
494 |
453 |
$41K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
778 |
699 |
$39K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
1,465 |
1,310 |
$19K |
| A4663 |
Blood pressure cuff only |
816 |
635 |
$17K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
181 |
169 |
$14K |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
192 |
177 |
$13K |
| E0156 |
Seat attachment, walker |
971 |
674 |
$12K |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
1,063 |
736 |
$10K |
| A7016 |
Dome and mouthpiece, used with small volume ultrasonic nebulizer |
1,477 |
1,321 |
$8K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
331 |
305 |
$4K |
| L8300 |
Truss, single with standard pad |
67 |
66 |
$4K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
33 |
26 |
$4K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
91 |
75 |
$4K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
67 |
52 |
$4K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
548 |
477 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,515 |
1,360 |
$2K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
307 |
270 |
$2K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
39 |
38 |
$2K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
107 |
87 |
$1K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
24 |
24 |
$1K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
13 |
12 |
$1K |
| K0001 |
Standard wheelchair |
42 |
26 |
$580.01 |
| A4217 |
Sterile water/saline, 500 ml |
110 |
81 |
$416.32 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
29 |
12 |
$305.54 |