| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
26,066 |
26,023 |
$1.02M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
24,214 |
24,179 |
$919K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
8,754 |
8,723 |
$848K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
9,843 |
9,829 |
$714K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
12,763 |
12,721 |
$340K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
8,251 |
8,219 |
$257K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
3,518 |
3,517 |
$193K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,251 |
1,251 |
$186K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
4,011 |
3,993 |
$68K |
| A4927 |
Gloves, non-sterile, per 100 |
14,594 |
14,512 |
$66K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
143 |
93 |
$11K |
| A4402 |
Lubricant, per ounce |
361 |
356 |
$2K |
| A4335 |
Incontinence supply; miscellaneous |
195 |
195 |
$1K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
19 |
13 |
$1K |
| E1399 |
Durable medical equipment, miscellaneous |
131 |
131 |
$798.76 |