| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,994 |
1,967 |
$263K |
| A4554 |
Disposable underpads, all sizes |
3,683 |
3,580 |
$257K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,751 |
1,727 |
$185K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,033 |
1,004 |
$139K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,144 |
2,065 |
$81K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
493 |
480 |
$49K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
1,734 |
1,652 |
$35K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
893 |
891 |
$28K |
| A4927 |
Gloves, non-sterile, per 100 |
2,715 |
2,635 |
$11K |
| E1399 |
Durable medical equipment, miscellaneous |
720 |
720 |
$4K |
| A4402 |
Lubricant, per ounce |
750 |
727 |
$4K |