| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
755 |
742 |
$41K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
288 |
284 |
$31K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
338 |
333 |
$23K |
| A4554 |
Disposable underpads, all sizes |
291 |
291 |
$22K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
295 |
291 |
$18K |
| K0001 |
Standard wheelchair |
231 |
223 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
335 |
320 |
$2K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
30 |
15 |
$328.65 |
| E0570 |
Nebulizer, with compressor |
51 |
51 |
$175.70 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
64 |
64 |
$167.76 |
| A4259 |
Lancets, per box of 100 |
245 |
236 |
$140.88 |