| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
14,313 |
13,248 |
$1.96M |
| T4541 |
Incontinence product, disposable underpad, large, each |
37,987 |
34,725 |
$1.64M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12,235 |
11,090 |
$1.60M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
11,630 |
10,691 |
$1.47M |
| A4927 |
Gloves, non-sterile, per 100 |
35,463 |
32,035 |
$1.04M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
15,351 |
13,821 |
$775K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
3,626 |
3,263 |
$378K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,957 |
2,740 |
$367K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
2,248 |
2,092 |
$289K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,278 |
1,102 |
$252K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,521 |
1,411 |
$199K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,193 |
1,933 |
$162K |
| A4553 |
Non-disposable underpads, all sizes |
6,513 |
5,823 |
$97K |
| K0003 |
Lightweight wheelchair |
1,842 |
1,696 |
$69K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,208 |
1,078 |
$56K |
| A4670 |
Automatic blood pressure monitor |
1,350 |
1,274 |
$49K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,142 |
2,041 |
$41K |
| A9286 |
Hygienic item or device, disposable or non-disposable, any type, each |
2,066 |
1,848 |
$35K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,556 |
1,377 |
$30K |
| E0570 |
Nebulizer, with compressor |
1,087 |
956 |
$18K |
| K0001 |
Standard wheelchair |
1,080 |
988 |
$13K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
453 |
335 |
$13K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
751 |
674 |
$9K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
471 |
417 |
$7K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
447 |
446 |
$7K |
| E0156 |
Seat attachment, walker |
612 |
537 |
$6K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
65 |
63 |
$6K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
308 |
270 |
$6K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
43 |
38 |
$5K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
449 |
317 |
$3K |
| A4259 |
Lancets, per box of 100 |
737 |
657 |
$2K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
45 |
37 |
$2K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
13 |
12 |
$2K |
| E0266 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress |
694 |
575 |
$2K |
| A4245 |
Alcohol wipes, per box |
243 |
227 |
$1K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
26 |
13 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
307 |
293 |
$606.01 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
26 |
13 |
$178.74 |
| E0607 |
Home blood glucose monitor |
16 |
13 |
$171.70 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
26 |
13 |
$123.87 |
| A4663 |
Blood pressure cuff only |
102 |
79 |
$93.26 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
65 |
58 |
$72.18 |
| A4258 |
Spring-powered device for lancet, each |
21 |
15 |
$27.96 |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
32 |
32 |
$0.00 |