| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,691 |
2,188 |
$100K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
547 |
493 |
$43K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
129 |
103 |
$12K |
| T4541 |
Incontinence product, disposable underpad, large, each |
253 |
248 |
$11K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
186 |
167 |
$10K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
14 |
12 |
$1K |
| E1399 |
Durable medical equipment, miscellaneous |
14 |
12 |
$942.31 |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
79 |
75 |
$0.00 |