| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
3,774 |
3,692 |
$308K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,924 |
1,894 |
$297K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,507 |
1,461 |
$235K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,990 |
2,927 |
$107K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
1,479 |
1,437 |
$28K |
| A4927 |
Gloves, non-sterile, per 100 |
2,563 |
2,516 |
$11K |