| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
2,288 |
2,277 |
$696K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,263 |
3,244 |
$528K |
| A4554 |
Disposable underpads, all sizes |
11,328 |
11,163 |
$403K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,704 |
2,691 |
$383K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,647 |
1,622 |
$335K |
| A4335 |
Incontinence supply; miscellaneous |
11,613 |
11,573 |
$64K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
7,738 |
7,709 |
$50K |
| K0002 |
Standard hemi (low seat) wheelchair |
2,367 |
2,313 |
$21K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
3,661 |
3,584 |
$10K |
| K0001 |
Standard wheelchair |
1,418 |
1,413 |
$10K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
452 |
442 |
$10K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
69 |
67 |
$8K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
530 |
521 |
$7K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
194 |
193 |
$5K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
1,750 |
1,735 |
$5K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
310 |
307 |
$5K |
| K0003 |
Lightweight wheelchair |
195 |
192 |
$2K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
40 |
39 |
$419.95 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
40 |
39 |
$369.84 |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
38 |
37 |
$165.41 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
14 |
14 |
$135.48 |