| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
1,298 |
1,297 |
$74K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
889 |
887 |
$51K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
860 |
860 |
$10K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
564 |
564 |
$5K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12 |
12 |
$684.00 |