| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
372 |
372 |
$51K |
| A4554 |
Disposable underpads, all sizes |
991 |
991 |
$44K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
356 |
356 |
$41K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
165 |
165 |
$28K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
513 |
513 |
$20K |
| A4335 |
Incontinence supply; miscellaneous |
1,263 |
1,263 |
$7K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
271 |
271 |
$4K |
| K0001 |
Standard wheelchair |
279 |
279 |
$1K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
271 |
271 |
$1K |