| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
21,555 |
21,543 |
$1.64M |
| A4554 |
Disposable underpads, all sizes |
45,484 |
45,459 |
$1.36M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
15,289 |
15,279 |
$1.14M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
32,118 |
32,101 |
$740K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
3,057 |
3,054 |
$458K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
11,213 |
11,201 |
$327K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
6,045 |
6,044 |
$299K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
3,075 |
2,519 |
$275K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
7,628 |
7,622 |
$240K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
2,194 |
1,769 |
$132K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
4,116 |
4,114 |
$73K |
| A4927 |
Gloves, non-sterile, per 100 |
6,926 |
6,917 |
$31K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
391 |
325 |
$28K |
| E1399 |
Durable medical equipment, miscellaneous |
600 |
599 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
455 |
455 |
$3K |
| A4670 |
Automatic blood pressure monitor |
33 |
33 |
$2K |
| A4402 |
Lubricant, per ounce |
310 |
309 |
$2K |