| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,863 |
2,802 |
$189K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
3,513 |
3,430 |
$149K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,472 |
1,443 |
$129K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
862 |
851 |
$121K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,440 |
1,405 |
$113K |
| T4541 |
Incontinence product, disposable underpad, large, each |
4,370 |
4,274 |
$98K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,256 |
1,219 |
$96K |
| W0137 |
|
2,744 |
2,664 |
$67K |
| A4927 |
Gloves, non-sterile, per 100 |
3,665 |
3,310 |
$58K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
311 |
305 |
$9K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
12 |
12 |
$2K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
30 |
26 |
$1K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$1K |
| A4335 |
Incontinence supply; miscellaneous |
45 |
38 |
$484.05 |
| K0001 |
Standard wheelchair |
26 |
25 |
$312.38 |