| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
8,903 |
5,693 |
$1.02M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
9,268 |
5,590 |
$887K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
8,930 |
2,948 |
$706K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,054 |
3,488 |
$464K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,805 |
1,617 |
$253K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,756 |
1,554 |
$243K |
| A4554 |
Disposable underpads, all sizes |
2,989 |
2,629 |
$175K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,455 |
1,275 |
$148K |
| A4335 |
Incontinence supply; miscellaneous |
5,991 |
3,449 |
$109K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
12,017 |
11,206 |
$76K |
| A4927 |
Gloves, non-sterile, per 100 |
5,225 |
3,234 |
$24K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
112 |
78 |
$8K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
31 |
25 |
$4K |
| K0003 |
Lightweight wheelchair |
196 |
134 |
$2K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
21 |
13 |
$892.44 |