| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
19,128 |
19,071 |
$1.00M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
13,639 |
13,608 |
$537K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
10,570 |
10,543 |
$536K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,032 |
3,024 |
$202K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
435 |
435 |
$24K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,154 |
1,148 |
$22K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
250 |
250 |
$21K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
263 |
262 |
$15K |
| K0003 |
Lightweight wheelchair |
1,150 |
1,147 |
$15K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
1,152 |
1,150 |
$12K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
1,797 |
1,783 |
$9K |
| E0245 |
Tub stool or bench |
182 |
182 |
$9K |
| 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 |
249 |
129 |
$6K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
209 |
209 |
$3K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
299 |
299 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
225 |
211 |
$1K |
| A4335 |
Incontinence supply; miscellaneous |
253 |
253 |
$1K |
| L0642 |
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, off-the-shelf |
13 |
13 |
$1K |
| A4259 |
Lancets, per box of 100 |
225 |
211 |
$862.50 |
| 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 |
255 |
129 |
$658.94 |
| E0156 |
Seat attachment, walker |
37 |
37 |
$440.45 |
| E0570 |
Nebulizer, with compressor |
171 |
166 |
$387.70 |