| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
688 |
602 |
$86K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
275 |
269 |
$41K |
| A4927 |
Gloves, non-sterile, per 100 |
1,271 |
1,157 |
$33K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
106 |
101 |
$6K |
| T4541 |
Incontinence product, disposable underpad, large, each |
133 |
128 |
$6K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
42 |
36 |
$729.47 |