| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
1,227 |
1,190 |
$93K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
422 |
413 |
$58K |
| A4927 |
Gloves, non-sterile, per 100 |
1,751 |
1,677 |
$41K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,297 |
1,229 |
$39K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
53 |
51 |
$6K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
37 |
36 |
$5K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
149 |
135 |
$3K |