| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,995 |
3,601 |
$306K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
7,161 |
6,557 |
$303K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,542 |
3,172 |
$292K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,654 |
1,501 |
$287K |
| T4541 |
Incontinence product, disposable underpad, large, each |
6,193 |
5,726 |
$196K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
3,195 |
2,850 |
$191K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,921 |
2,570 |
$188K |
| A4927 |
Gloves, non-sterile, per 100 |
4,325 |
3,955 |
$61K |
| E0601 |
Continuous positive airway pressure (cpap) device |
486 |
379 |
$22K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
237 |
210 |
$11K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
162 |
160 |
$3K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
13 |
13 |
$592.90 |
| E0241 |
Bath tub wall rail, each |
12 |
12 |
$288.00 |