| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
911 |
894 |
$78K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
881 |
803 |
$52K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
607 |
598 |
$36K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
264 |
263 |
$23K |
| A4554 |
Disposable underpads, all sizes |
405 |
403 |
$12K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
12 |
12 |
$464.11 |
| K0003 |
Lightweight wheelchair |
12 |
12 |
$230.58 |