| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
2,895 |
2,889 |
$138K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
964 |
961 |
$62K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
907 |
907 |
$48K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
418 |
418 |
$35K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
482 |
482 |
$19K |
| E0570 |
Nebulizer, with compressor |
255 |
255 |
$17K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
219 |
219 |
$14K |
| K0001 |
Standard wheelchair |
412 |
317 |
$13K |
| S9999 |
Sales tax |
1,083 |
1,038 |
$9K |
| E0245 |
Tub stool or bench |
135 |
135 |
$6K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
65 |
65 |
$6K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
52 |
52 |
$4K |
| E1031 |
Rollabout chair, any and all types with casters 5" or greater |
109 |
109 |
$0.00 |