| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X1939 |
|
4,057 |
3,898 |
$252K |
| A4554 |
Disposable underpads, all sizes |
4,819 |
4,673 |
$153K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,687 |
1,632 |
$110K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,603 |
2,535 |
$74K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,443 |
1,390 |
$72K |
| T5999 |
Supply, not otherwise specified |
9,232 |
8,949 |
$63K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
399 |
398 |
$53K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
654 |
617 |
$29K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
15 |
15 |
$2K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
16 |
16 |
$1K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
16 |
16 |
$1K |