| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
374 |
370 |
$50K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
181 |
178 |
$19K |
| T4541 |
Incontinence product, disposable underpad, large, each |
874 |
854 |
$15K |
| A4927 |
Gloves, non-sterile, per 100 |
797 |
768 |
$9K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
13 |
12 |
$2K |