| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,704 |
2,642 |
$598K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,153 |
3,148 |
$491K |
| A4554 |
Disposable underpads, all sizes |
8,390 |
8,317 |
$311K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,073 |
2,050 |
$284K |
| A4335 |
Incontinence supply; miscellaneous |
8,494 |
8,435 |
$45K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
166 |
80 |
$2K |