| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,890 |
3,876 |
$570K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,401 |
2,390 |
$428K |
| A4554 |
Disposable underpads, all sizes |
8,768 |
8,730 |
$327K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
342 |
342 |
$103K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
417 |
416 |
$88K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
530 |
530 |
$66K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
8,841 |
8,809 |
$48K |
| A4335 |
Incontinence supply; miscellaneous |
8,849 |
8,820 |
$48K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
184 |
184 |
$2K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
997 |
990 |
$2K |
| K0003 |
Lightweight wheelchair |
91 |
91 |
$585.06 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
132 |
132 |
$271.58 |