| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,530 |
3,502 |
$523K |
| A4554 |
Disposable underpads, all sizes |
10,630 |
10,504 |
$372K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,321 |
1,297 |
$242K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,080 |
4,035 |
$198K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,495 |
1,459 |
$187K |
| A4335 |
Incontinence supply; miscellaneous |
10,722 |
10,580 |
$58K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,088 |
1,078 |
$6K |
| K0003 |
Lightweight wheelchair |
325 |
325 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
101 |
101 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
465 |
459 |
$4K |