| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
6,546 |
3,254 |
$960K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
7,497 |
7,465 |
$877K |
| A4554 |
Disposable underpads, all sizes |
24,842 |
24,670 |
$875K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
16,512 |
16,396 |
$634K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,073 |
5,057 |
$459K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,324 |
3,294 |
$421K |
| A4335 |
Incontinence supply; miscellaneous |
28,567 |
28,237 |
$153K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
536 |
533 |
$52K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
396 |
393 |
$31K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
240 |
237 |
$14K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
405 |
397 |
$10K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
61 |
61 |
$7K |
| K0003 |
Lightweight wheelchair |
538 |
538 |
$5K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
26 |
26 |
$3K |
| A4259 |
Lancets, per box of 100 |
206 |
205 |
$1K |
| A4670 |
Automatic blood pressure monitor |
26 |
26 |
$1K |
| A4245 |
Alcohol wipes, per box |
142 |
141 |
$200.50 |