| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,534 |
1,508 |
$195K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,696 |
2,646 |
$175K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,248 |
2,217 |
$107K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
150 |
149 |
$18K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
65 |
65 |
$7K |
| A4927 |
Gloves, non-sterile, per 100 |
383 |
383 |
$5K |