| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
1,988 |
1,118 |
$172K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,270 |
1,213 |
$90K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
563 |
553 |
$79K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
467 |
454 |
$52K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
497 |
488 |
$52K |
| T4541 |
Incontinence product, disposable underpad, large, each |
971 |
957 |
$41K |
| A4927 |
Gloves, non-sterile, per 100 |
414 |
391 |
$16K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
229 |
209 |
$8K |
| K0001 |
Standard wheelchair |
233 |
225 |
$5K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
640 |
308 |
$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 |
15 |
12 |
$2K |