| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X1939 |
|
4,502 |
4,493 |
$284K |
| A4554 |
Disposable underpads, all sizes |
5,053 |
5,011 |
$160K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,081 |
1,068 |
$69K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,495 |
1,495 |
$67K |
| T5999 |
Supply, not otherwise specified |
10,126 |
10,033 |
$63K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,951 |
1,941 |
$55K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
876 |
871 |
$43K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
41 |
38 |
$5K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
17 |
17 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
18 |
18 |
$1K |