| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
4,255 |
4,227 |
$239K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,949 |
3,528 |
$185K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,854 |
1,842 |
$134K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,288 |
1,281 |
$77K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
2,301 |
2,264 |
$35K |
| A4335 |
Incontinence supply; miscellaneous |
2,260 |
2,252 |
$19K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
219 |
218 |
$15K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
81 |
81 |
$5K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
52 |
52 |
$5K |
| K0001 |
Standard wheelchair |
149 |
149 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
227 |
177 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
57 |
57 |
$423.13 |
| A4259 |
Lancets, per box of 100 |
278 |
225 |
$148.24 |