| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
9,545 |
8,384 |
$621K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,138 |
2,827 |
$520K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
8,529 |
7,574 |
$387K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,392 |
1,227 |
$337K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,884 |
1,609 |
$268K |
| A4670 |
Automatic blood pressure monitor |
4,324 |
3,894 |
$266K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,841 |
1,618 |
$260K |
| A4459 |
Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type |
40 |
24 |
$87K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
458 |
406 |
$75K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,033 |
936 |
$66K |
| A4927 |
Gloves, non-sterile, per 100 |
7,932 |
6,694 |
$52K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
408 |
296 |
$50K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
485 |
422 |
$48K |
| L1920 |
Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated |
237 |
142 |
$33K |
| E0570 |
Nebulizer, with compressor |
632 |
600 |
$21K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
143 |
108 |
$17K |
| E0156 |
Seat attachment, walker |
1,115 |
1,003 |
$15K |
| K0001 |
Standard wheelchair |
180 |
164 |
$13K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
220 |
197 |
$11K |
| E1639 |
Scale, each |
369 |
360 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
76 |
76 |
$6K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
44 |
39 |
$6K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,010 |
892 |
$5K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
31 |
25 |
$4K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
30 |
24 |
$3K |
| L0627 |
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 item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
13 |
13 |
$3K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
20 |
13 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
34 |
24 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
49 |
46 |
$2K |
| A4663 |
Blood pressure cuff only |
217 |
215 |
$640.26 |
| 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 |
25 |
24 |
$603.64 |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
14 |
13 |
$576.39 |
| 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 |
12 |
12 |
$480.95 |