| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
3,064 |
3,063 |
$313K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,119 |
2,115 |
$265K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,168 |
1,167 |
$158K |
| A4554 |
Disposable underpads, all sizes |
2,015 |
2,014 |
$139K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
756 |
755 |
$77K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,171 |
1,171 |
$46K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
506 |
506 |
$30K |
| B4100 |
Food thickener, administered orally, per ounce |
12 |
12 |
$1K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
24 |
24 |
$517.68 |