| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
3,014 |
2,385 |
$343K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,894 |
1,468 |
$196K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,472 |
1,198 |
$129K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
587 |
496 |
$90K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
513 |
371 |
$58K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
244 |
167 |
$23K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
89 |
81 |
$17K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
194 |
115 |
$4K |
| E0570 |
Nebulizer, with compressor |
16 |
12 |
$472.50 |