| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
1,465 |
1,447 |
$51K |
| A4335 |
Incontinence supply; miscellaneous |
2,384 |
2,337 |
$12K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
56 |
54 |
$7K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
36 |
36 |
$7K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
26 |
25 |
$948.59 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
18 |
12 |
$256.80 |