| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
10,228 |
9,632 |
$605K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,744 |
4,475 |
$469K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,637 |
3,454 |
$424K |
| T4541 |
Incontinence product, disposable underpad, large, each |
8,733 |
8,228 |
$372K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,850 |
3,605 |
$333K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,267 |
1,197 |
$179K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
757 |
712 |
$125K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
735 |
733 |
$80K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
895 |
841 |
$72K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
237 |
222 |
$32K |
| A4927 |
Gloves, non-sterile, per 100 |
646 |
596 |
$25K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
270 |
270 |
$24K |
| E1399 |
Durable medical equipment, miscellaneous |
388 |
365 |
$21K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
732 |
732 |
$19K |
| A4335 |
Incontinence supply; miscellaneous |
315 |
294 |
$11K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
495 |
441 |
$9K |
| K0001 |
Standard wheelchair |
299 |
299 |
$3K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
28 |
28 |
$2K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
14 |
12 |
$1K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
39 |
39 |
$1K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
55 |
51 |
$871.64 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
68 |
68 |
$260.30 |