| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,989 |
1,902 |
$324K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,893 |
1,813 |
$130K |
| A4554 |
Disposable underpads, all sizes |
1,953 |
1,862 |
$84K |
| A4927 |
Gloves, non-sterile, per 100 |
1,827 |
1,737 |
$35K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
890 |
860 |
$11K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
132 |
130 |
$2K |
| A4553 |
Non-disposable underpads, all sizes |
16 |
16 |
$257.07 |