| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,598 |
2,407 |
$195K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,788 |
1,589 |
$161K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,224 |
2,859 |
$157K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,149 |
2,036 |
$155K |
| T4541 |
Incontinence product, disposable underpad, large, each |
396 |
388 |
$23K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
89 |
86 |
$11K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
191 |
187 |
$6K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$2K |
| K0001 |
Standard wheelchair |
24 |
24 |
$560.32 |
| E0570 |
Nebulizer, with compressor |
12 |
12 |
$153.22 |