| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
2,903 |
2,823 |
$200K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,007 |
986 |
$161K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,148 |
2,095 |
$95K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
526 |
507 |
$65K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
449 |
408 |
$53K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
716 |
659 |
$39K |
| A4670 |
Automatic blood pressure monitor |
489 |
467 |
$31K |
| A4927 |
Gloves, non-sterile, per 100 |
460 |
455 |
$7K |
| E0570 |
Nebulizer, with compressor |
13 |
13 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
52 |
50 |
$630.36 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
15 |
12 |
$509.48 |