| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,518 |
1,359 |
$47K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
278 |
248 |
$45K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,677 |
1,501 |
$31K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
126 |
106 |
$18K |
| A4927 |
Gloves, non-sterile, per 100 |
865 |
740 |
$14K |
| K0001 |
Standard wheelchair |
611 |
558 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
253 |
249 |
$7K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
40 |
37 |
$6K |
| E0570 |
Nebulizer, with compressor |
110 |
109 |
$4K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
12 |
12 |
$946.40 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
67 |
65 |
$239.75 |
| A4335 |
Incontinence supply; miscellaneous |
16 |
12 |
$115.68 |