| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
549 |
526 |
$31K |
| T4541 |
Incontinence product, disposable underpad, large, each |
606 |
585 |
$28K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
607 |
585 |
$15K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
559 |
540 |
$7K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
951 |
795 |
$5K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
323 |
316 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
321 |
310 |
$701.50 |
| A4259 |
Lancets, per box of 100 |
868 |
730 |
$331.61 |