| Code | Description | Claims | Beneficiaries | Total Paid |
| A4554 |
Disposable underpads, all sizes |
36,726 |
36,422 |
$1.33M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
9,980 |
9,915 |
$1.19M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
25,019 |
23,966 |
$1.09M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
7,392 |
7,340 |
$800K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,739 |
4,704 |
$692K |
| A4335 |
Incontinence supply; miscellaneous |
41,049 |
40,232 |
$222K |
| E0570 |
Nebulizer, with compressor |
2,678 |
2,654 |
$200K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
679 |
675 |
$74K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,738 |
2,382 |
$54K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
173 |
165 |
$38K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
322 |
320 |
$37K |
| A4670 |
Automatic blood pressure monitor |
613 |
603 |
$36K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
142 |
142 |
$21K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
187 |
186 |
$17K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
91 |
90 |
$14K |
| A4259 |
Lancets, per box of 100 |
2,154 |
2,077 |
$10K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,431 |
2,396 |
$4K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,443 |
2,403 |
$3K |
| K0003 |
Lightweight wheelchair |
199 |
191 |
$2K |
| A4245 |
Alcohol wipes, per box |
1,292 |
1,254 |
$2K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
13 |
13 |
$1K |
| K0001 |
Standard wheelchair |
89 |
88 |
$371.62 |
| 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 |
12 |
12 |
$0.00 |
| 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 |
$0.00 |