| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
238 |
221 |
$25K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
166 |
140 |
$13K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
153 |
143 |
$12K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
12 |
12 |
$3K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
27 |
26 |
$2K |