| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,146 |
2,127 |
$408K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,576 |
2,559 |
$380K |
| A4554 |
Disposable underpads, all sizes |
8,877 |
8,807 |
$321K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,152 |
2,134 |
$294K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,285 |
1,274 |
$288K |
| A4335 |
Incontinence supply; miscellaneous |
9,672 |
9,556 |
$51K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
963 |
945 |
$27K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
829 |
823 |
$21K |
| A4927 |
Gloves, non-sterile, per 100 |
1,174 |
1,157 |
$8K |
| K0003 |
Lightweight wheelchair |
171 |
169 |
$3K |
| K0004 |
High strength, lightweight wheelchair |
150 |
150 |
$2K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
12 |
12 |
$2K |
| E0570 |
Nebulizer, with compressor |
386 |
376 |
$829.99 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
118 |
118 |
$544.34 |