| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
43,657 |
43,618 |
$1.55M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
45,611 |
45,585 |
$1.53M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
14,325 |
14,310 |
$1.28M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
15,151 |
15,138 |
$1.17M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
4,019 |
4,017 |
$699K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
24,143 |
24,131 |
$630K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
15,257 |
15,244 |
$508K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
7,770 |
7,764 |
$430K |
| A4927 |
Gloves, non-sterile, per 100 |
35,088 |
35,073 |
$161K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
4,992 |
4,986 |
$87K |
| E0570 |
Nebulizer, with compressor |
588 |
588 |
$49K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,714 |
1,713 |
$26K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
386 |
229 |
$23K |
| A4335 |
Incontinence supply; miscellaneous |
1,750 |
1,748 |
$8K |
| A4402 |
Lubricant, per ounce |
547 |
546 |
$4K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
50 |
38 |
$3K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
48 |
48 |
$2K |
| K0003 |
Lightweight wheelchair |
306 |
306 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
86 |
86 |
$1K |
| E1399 |
Durable medical equipment, miscellaneous |
253 |
252 |
$1K |
| A4259 |
Lancets, per box of 100 |
72 |
72 |
$314.73 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
12 |
12 |
$225.93 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
115 |
115 |
$210.17 |
| A4245 |
Alcohol wipes, per box |
73 |
73 |
$96.08 |
| E0156 |
Seat attachment, walker |
12 |
12 |
$61.17 |