| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
348 |
347 |
$18K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
98 |
98 |
$6K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
261 |
261 |
$4K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
51 |
51 |
$3K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
24 |
15 |
$225.44 |