| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
14,661 |
14,586 |
$416K |
| A4554 |
Disposable underpads, all sizes |
10,563 |
10,522 |
$263K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
2,800 |
1,934 |
$220K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,940 |
2,921 |
$182K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,385 |
2,370 |
$111K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
1,786 |
1,250 |
$94K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,507 |
1,500 |
$90K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
2,608 |
2,582 |
$68K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,382 |
1,372 |
$42K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
302 |
206 |
$18K |
| A4927 |
Gloves, non-sterile, per 100 |
2,657 |
2,631 |
$12K |
| A4670 |
Automatic blood pressure monitor |
143 |
143 |
$6K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
64 |
64 |
$528.13 |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
21 |
12 |
$386.54 |