| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,854 |
3,852 |
$549K |
| A4554 |
Disposable underpads, all sizes |
12,829 |
12,794 |
$468K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
7,867 |
7,859 |
$403K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,333 |
2,331 |
$256K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,383 |
1,383 |
$226K |
| A4335 |
Incontinence supply; miscellaneous |
13,874 |
13,772 |
$76K |
| A4927 |
Gloves, non-sterile, per 100 |
2,591 |
2,585 |
$19K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
79 |
76 |
$12K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
810 |
783 |
$6K |
| E0570 |
Nebulizer, with compressor |
40 |
40 |
$4K |
| A4245 |
Alcohol wipes, per box |
1,615 |
1,612 |
$3K |
| A4259 |
Lancets, per box of 100 |
939 |
936 |
$2K |
| K0003 |
Lightweight wheelchair |
12 |
12 |
$146.88 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
13 |
13 |
$25.04 |
| A7015 |
Aerosol mask, used with dme nebulizer |
13 |
13 |
$17.05 |