| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
164 |
161 |
$19K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
156 |
154 |
$16K |
| A4554 |
Disposable underpads, all sizes |
485 |
480 |
$13K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
99 |
98 |
$12K |
| A4335 |
Incontinence supply; miscellaneous |
536 |
528 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
81 |
70 |
$1.48 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
59 |
50 |
$0.00 |
| 90661 |
|
16 |
16 |
$0.00 |
| E0570 |
Nebulizer, with compressor |
59 |
50 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
16 |
16 |
$0.00 |