| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
3,771 |
3,722 |
$135K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,127 |
2,115 |
$77K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
482 |
474 |
$66K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
344 |
344 |
$42K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
402 |
400 |
$37K |
| A4335 |
Incontinence supply; miscellaneous |
4,288 |
4,236 |
$23K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
51 |
47 |
$7K |
| K0003 |
Lightweight wheelchair |
121 |
121 |
$868.08 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
12 |
12 |
$22.20 |
| A7015 |
Aerosol mask, used with dme nebulizer |
12 |
12 |
$15.12 |