| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
658 |
658 |
$96K |
| A4554 |
Disposable underpads, all sizes |
1,585 |
1,584 |
$58K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
147 |
147 |
$18K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
101 |
101 |
$17K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
390 |
388 |
$15K |
| A4335 |
Incontinence supply; miscellaneous |
1,592 |
1,591 |
$9K |
| K0001 |
Standard wheelchair |
182 |
182 |
$2K |