| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
12,863 |
11,807 |
$531K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,475 |
4,178 |
$502K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
9,036 |
8,270 |
$429K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,304 |
2,985 |
$366K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,519 |
2,388 |
$284K |
| A4927 |
Gloves, non-sterile, per 100 |
12,218 |
11,168 |
$158K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
960 |
864 |
$121K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
3,885 |
3,605 |
$93K |
| A4670 |
Automatic blood pressure monitor |
1,033 |
870 |
$54K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
364 |
349 |
$46K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
320 |
280 |
$33K |
| E0570 |
Nebulizer, with compressor |
999 |
844 |
$31K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
298 |
253 |
$20K |
| A4259 |
Lancets, per box of 100 |
3,846 |
3,583 |
$13K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
511 |
430 |
$7K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
24 |
24 |
$5K |
| E0607 |
Home blood glucose monitor |
76 |
76 |
$3K |
| 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 |
70 |
50 |
$2K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
17 |
14 |
$2K |
| 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 |
70 |
50 |
$2K |
| A4258 |
Spring-powered device for lancet, each |
76 |
75 |
$777.94 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
106 |
74 |
$630.07 |
| A7015 |
Aerosol mask, used with dme nebulizer |
489 |
414 |
$622.38 |
| A4256 |
Normal, low and high calibrator solution / chips |
26 |
26 |
$165.02 |
| K0001 |
Standard wheelchair |
28 |
25 |
$113.05 |