| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
1,038 |
1,036 |
$55K |
| K0862 |
Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
15 |
15 |
$50K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
446 |
445 |
$38K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
143 |
140 |
$8K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
131 |
131 |
$6K |
| A4927 |
Gloves, non-sterile, per 100 |
493 |
481 |
$5K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
12 |
12 |
$774.96 |