| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
4,807 |
4,684 |
$394K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,518 |
1,493 |
$263K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
803 |
801 |
$136K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
908 |
903 |
$115K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,685 |
2,614 |
$81K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
225 |
225 |
$27K |
| A4927 |
Gloves, non-sterile, per 100 |
3,240 |
3,170 |
$14K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
216 |
213 |
$10K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
417 |
417 |
$10K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
106 |
105 |
$2K |