| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
889 |
789 |
$55K |
| A4554 |
Disposable underpads, all sizes |
1,458 |
1,380 |
$41K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
386 |
356 |
$40K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
394 |
358 |
$37K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
219 |
199 |
$12K |
| A4927 |
Gloves, non-sterile, per 100 |
419 |
401 |
$6K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
52 |
49 |
$5K |