| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4335 |
Incontinence supply; miscellaneous |
3,495 |
3,473 |
$73K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
1,124 |
1,111 |
$70K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
185 |
183 |
$6K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,370 |
1,350 |
$293.28 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,013 |
999 |
$249.92 |
| A4554 |
Disposable underpads, all sizes |
3,180 |
3,161 |
$71.40 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
577 |
576 |
$40.00 |
| A4927 |
Gloves, non-sterile, per 100 |
1,628 |
1,616 |
$17.50 |
| S5199 |
Personal care item, nos, each |
4,060 |
4,035 |
$1.14 |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,323 |
1,306 |
$0.00 |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
515 |
506 |
$0.00 |
| S9999 |
Sales tax |
920 |
917 |
$0.00 |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
61 |
59 |
$0.00 |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
121 |
120 |
$0.00 |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
111 |
111 |
$0.00 |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
124 |
123 |
$0.00 |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
77 |
74 |
$0.00 |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
210 |
209 |
$0.00 |