| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
8,789 |
8,648 |
$1.51M |
| T4541 |
Incontinence product, disposable underpad, large, each |
21,454 |
21,144 |
$1.43M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
9,647 |
9,510 |
$1.30M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
24,101 |
23,786 |
$1.14M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,264 |
2,230 |
$309K |
| A4927 |
Gloves, non-sterile, per 100 |
20,371 |
20,081 |
$187K |
| A6536 |
Gradient compression stocking, full length/chap style, 18-30 mmhg, each |
1,486 |
1,459 |
$151K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
327 |
316 |
$32K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
418 |
405 |
$27K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
220 |
211 |
$24K |
| 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 |
153 |
152 |
$7K |
| 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 |
153 |
152 |
$5K |
| A4670 |
Automatic blood pressure monitor |
71 |
71 |
$4K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
918 |
917 |
$4K |
| L0627 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
15 |
12 |
$3K |
| A4259 |
Lancets, per box of 100 |
916 |
915 |
$345.28 |