| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,242 |
1,224 |
$114K |
| A4554 |
Disposable underpads, all sizes |
4,085 |
3,854 |
$104K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,021 |
930 |
$67K |
| A4927 |
Gloves, non-sterile, per 100 |
2,558 |
2,396 |
$32K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
357 |
343 |
$28K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
110 |
106 |
$10K |
| K0001 |
Standard wheelchair |
12 |
12 |
$65.45 |