| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,293 |
2,290 |
$331K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,215 |
2,214 |
$280K |
| A4554 |
Disposable underpads, all sizes |
6,991 |
6,974 |
$257K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,022 |
1,022 |
$175K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,855 |
2,852 |
$122K |
| A4335 |
Incontinence supply; miscellaneous |
7,638 |
7,629 |
$42K |
| K0001 |
Standard wheelchair |
1,228 |
1,225 |
$10K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
464 |
463 |
$9K |
| K0003 |
Lightweight wheelchair |
300 |
299 |
$4K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
464 |
463 |
$2K |
| E0570 |
Nebulizer, with compressor |
88 |
87 |
$70.84 |