| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
4,350 |
4,348 |
$209K |
| K0003 |
Lightweight wheelchair |
1,471 |
1,470 |
$145K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,759 |
1,759 |
$115K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
763 |
763 |
$53K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
914 |
913 |
$50K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
639 |
639 |
$27K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
182 |
178 |
$20K |
| E2603 |
Skin protection wheelchair seat cushion, width less than 22 inches, any depth |
186 |
181 |
$15K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
132 |
128 |
$11K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
94 |
94 |
$5K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
420 |
419 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
367 |
367 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
966 |
965 |
$1K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
13 |
13 |
$593.19 |