| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
732 |
710 |
$62K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
928 |
786 |
$52K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,163 |
1,054 |
$50K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
378 |
298 |
$16K |
| T1030 |
Nursing care, in the home, by registered nurse, per diem |
345 |
132 |
$15K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
91 |
87 |
$8K |
| 90694 |
|
14 |
14 |
$549.00 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$158.20 |