| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
648 |
646 |
$52K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
644 |
639 |
$39K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
276 |
274 |
$23K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
213 |
212 |
$20K |
| T5999 |
Supply, not otherwise specified |
97 |
88 |
$12K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
173 |
166 |
$11K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
63 |
63 |
$8K |
| K0001 |
Standard wheelchair |
176 |
176 |
$7K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
77 |
75 |
$342.43 |