| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
43,105 |
40,501 |
$1.59M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
15,969 |
14,967 |
$1.20M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12,041 |
11,429 |
$956K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
10,001 |
9,446 |
$930K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
7,468 |
7,033 |
$904K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
7,154 |
6,710 |
$636K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
7,114 |
6,640 |
$526K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
6,843 |
6,511 |
$389K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
8,644 |
8,062 |
$284K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,118 |
1,080 |
$92K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
1,820 |
1,725 |
$88K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
1,237 |
855 |
$86K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
265 |
243 |
$78K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
300 |
289 |
$77K |
| K0003 |
Lightweight wheelchair |
2,351 |
2,169 |
$46K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,503 |
1,080 |
$37K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,003 |
941 |
$36K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,318 |
2,177 |
$32K |
| E0245 |
Tub stool or bench |
221 |
193 |
$13K |
| E0570 |
Nebulizer, with compressor |
2,118 |
2,040 |
$13K |
| A4670 |
Automatic blood pressure monitor |
162 |
155 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,297 |
1,203 |
$5K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
108 |
101 |
$5K |
| E0156 |
Seat attachment, walker |
185 |
169 |
$745.42 |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
45 |
28 |
$736.61 |
| 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 |
31 |
28 |
$697.65 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
543 |
520 |
$494.88 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
49 |
48 |
$374.37 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
33 |
32 |
$173.83 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
12 |
12 |
$29.49 |
| E0555 |
Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter |
113 |
111 |
$0.00 |
| A4616 |
Tubing (oxygen), per foot |
148 |
143 |
$0.00 |
| A4615 |
Cannula, nasal |
148 |
143 |
$0.00 |