| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
531 |
524 |
$29K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
468 |
460 |
$19K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
126 |
124 |
$14K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
384 |
377 |
$12K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
25 |
25 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
206 |
204 |
$938.40 |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
25 |
25 |
$628.80 |