| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
2,139 |
1,993 |
$247K |
| A4554 |
Disposable underpads, all sizes |
6,354 |
5,860 |
$213K |
| T5999 |
Supply, not otherwise specified |
10,928 |
9,568 |
$113K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,519 |
3,328 |
$106K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,379 |
1,308 |
$69K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
765 |
745 |
$58K |
| X1939 |
|
1,049 |
1,011 |
$56K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
376 |
357 |
$51K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
949 |
846 |
$44K |
| A4927 |
Gloves, non-sterile, per 100 |
2,284 |
1,525 |
$22K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
161 |
142 |
$10K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
33 |
30 |
$4K |
| E0570 |
Nebulizer, with compressor |
233 |
217 |
$3K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
15 |
15 |
$2K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
13 |
13 |
$1K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
12 |
12 |
$1K |