| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4927 |
Gloves, non-sterile, per 100 |
53,443 |
52,965 |
$1.37M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12,504 |
12,435 |
$1.15M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
14,511 |
14,445 |
$1.12M |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
17,402 |
17,349 |
$703K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
19,507 |
19,355 |
$642K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
6,161 |
6,131 |
$600K |
| T4541 |
Incontinence product, disposable underpad, large, each |
12,102 |
12,036 |
$512K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
5,020 |
4,992 |
$466K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,998 |
2,987 |
$336K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,941 |
2,928 |
$208K |
| A4335 |
Incontinence supply; miscellaneous |
6,973 |
6,588 |
$179K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,088 |
1,058 |
$175K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,523 |
1,513 |
$122K |
| S9999 |
Sales tax |
9,076 |
3,967 |
$65K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
200 |
199 |
$19K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
66 |
65 |
$13K |