| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,119 |
1,825 |
$203K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,850 |
1,657 |
$167K |
| A4554 |
Disposable underpads, all sizes |
3,248 |
2,860 |
$149K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,652 |
1,350 |
$121K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,181 |
1,082 |
$96K |
| A4927 |
Gloves, non-sterile, per 100 |
3,859 |
3,274 |
$49K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
433 |
413 |
$9K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
32 |
24 |
$2K |