| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
49 |
49 |
$2K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
13 |
13 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
32 |
32 |
$1K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
112 |
111 |
$1K |
| A4554 |
Disposable underpads, all sizes |
39 |
38 |
$800.12 |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
18 |
18 |
$775.93 |
| A4927 |
Gloves, non-sterile, per 100 |
56 |
56 |
$245.91 |
| A4335 |
Incontinence supply; miscellaneous |
33 |
33 |
$103.86 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
185 |
169 |
$90.00 |