| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
4,245 |
3,372 |
$133K |
| T5999 |
Supply, not otherwise specified |
7,314 |
5,786 |
$66K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
691 |
566 |
$39K |
| X1939 |
|
550 |
546 |
$37K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
176 |
150 |
$12K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
169 |
143 |
$11K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
369 |
355 |
$11K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
20 |
16 |
$2K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
14 |
12 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
16 |
13 |
$1K |