| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,963 |
1,928 |
$180K |
| A4927 |
Gloves, non-sterile, per 100 |
9,373 |
9,094 |
$167K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,682 |
1,650 |
$166K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,621 |
1,564 |
$149K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
910 |
894 |
$100K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,439 |
1,419 |
$81K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
3,416 |
3,334 |
$77K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
851 |
828 |
$24K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
130 |
129 |
$16K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
14 |
12 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
583 |
408 |
$0.00 |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
38 |
38 |
$0.00 |
| 90480 |
|
41 |
30 |
$0.00 |
| 90688 |
|
174 |
145 |
$0.00 |
| 90656 |
|
24 |
14 |
$0.00 |
| 90686 |
|
43 |
25 |
$0.00 |
| 91322 |
|
41 |
30 |
$0.00 |
| 90653 |
|
64 |
36 |
$0.00 |
| 90662 |
|
251 |
171 |
$0.00 |