| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,757 |
1,251 |
$152K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,744 |
1,317 |
$146K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,841 |
1,393 |
$143K |
| A4927 |
Gloves, non-sterile, per 100 |
9,396 |
6,415 |
$109K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,256 |
1,017 |
$99K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
668 |
541 |
$53K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,100 |
913 |
$48K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
550 |
391 |
$32K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
806 |
655 |
$26K |
| A4930 |
Gloves, sterile, per pair |
239 |
205 |
$12K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,051 |
843 |
$8K |
| A4259 |
Lancets, per box of 100 |
253 |
201 |
$421.05 |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
24 |
13 |
$187.80 |