| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
499 |
498 |
$108K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
723 |
722 |
$108K |
| A4554 |
Disposable underpads, all sizes |
2,686 |
2,667 |
$100K |
| A4335 |
Incontinence supply; miscellaneous |
3,992 |
3,966 |
$21K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
172 |
171 |
$21K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
570 |
570 |
$20K |
| E0570 |
Nebulizer, with compressor |
341 |
339 |
$12K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
37 |
37 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
42 |
40 |
$720.26 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
41 |
39 |
$39.58 |