| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
6,373 |
6,324 |
$450K |
| A4554 |
Disposable underpads |
14,187 |
14,121 |
$369K |
| T4535 |
Disposable liner/shield/pad |
10,240 |
10,167 |
$236K |
| T4524 |
Adult size brief/diaper xl |
3,619 |
3,603 |
$225K |
| T4522 |
Adult size brief/diaper med |
1,898 |
1,891 |
$98K |
| T4539 |
Reuse diaper/brief any size |
2,949 |
2,905 |
$79K |
| T4543 |
Adult disp brief/diap abv xl |
694 |
691 |
$69K |
| T4537 |
Reusable underpad bed size |
1,682 |
1,658 |
$53K |
| T4540 |
Reusable underpad chair size |
572 |
562 |
$11K |
| A4927 |
Non-sterile gloves |
863 |
837 |
$4K |