| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
604 |
593 |
$60K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
749 |
725 |
$60K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
481 |
472 |
$45K |
| T4541 |
Incontinence product, disposable underpad, large, each |
894 |
861 |
$37K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,006 |
976 |
$31K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
825 |
816 |
$31K |
| A4927 |
Gloves, non-sterile, per 100 |
2,199 |
2,152 |
$24K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
12 |
12 |
$1K |
| K0001 |
Standard wheelchair |
13 |
12 |
$783.11 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
38 |
36 |
$288.33 |