| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
905 |
904 |
$150K |
| A4554 |
Disposable underpads, all sizes |
3,373 |
3,293 |
$120K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
723 |
722 |
$105K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
470 |
469 |
$92K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
699 |
699 |
$26K |
| A4335 |
Incontinence supply; miscellaneous |
3,284 |
3,277 |
$19K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
413 |
406 |
$7K |
| K0002 |
Standard hemi (low seat) wheelchair |
405 |
395 |
$6K |
| A4670 |
Automatic blood pressure monitor |
14 |
14 |
$809.90 |
| A9286 |
Hygienic item or device, disposable or non-disposable, any type, each |
62 |
62 |
$0.00 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
110 |
98 |
$0.00 |
| A5120 |
Skin barrier, wipes or swabs, each |
44 |
41 |
$0.00 |