| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
15,012 |
14,886 |
$1.07M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
3,224 |
3,197 |
$902K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
14,822 |
14,696 |
$742K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,383 |
4,344 |
$659K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,427 |
3,401 |
$637K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,569 |
2,546 |
$385K |
| A4927 |
Gloves, non-sterile, per 100 |
15,053 |
14,924 |
$232K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
67 |
65 |
$8K |
| K0003 |
Lightweight wheelchair |
243 |
243 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
146 |
146 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
528 |
528 |
$1K |