| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,624 |
2,600 |
$223K |
| A4927 |
Gloves, non-sterile, per 100 |
7,176 |
7,061 |
$197K |
| A4554 |
Disposable underpads, all sizes |
4,780 |
4,746 |
$173K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,274 |
2,248 |
$148K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
1,215 |
1,181 |
$140K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,240 |
1,228 |
$127K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
1,268 |
1,251 |
$123K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,299 |
3,656 |
$100K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
1,619 |
778 |
$52K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
386 |
375 |
$46K |
| L3217 |
Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
61 |
60 |
$8K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
1,500 |
1,407 |
$5K |