| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
15,710 |
14,412 |
$661K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
6,270 |
5,768 |
$570K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
6,631 |
6,060 |
$543K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,859 |
5,419 |
$521K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
7,652 |
7,022 |
$421K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
386 |
277 |
$384K |
| A4927 |
Gloves, non-sterile, per 100 |
19,799 |
18,131 |
$199K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,367 |
2,023 |
$190K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,726 |
1,539 |
$150K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,393 |
1,249 |
$101K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
191 |
133 |
$10K |
| E0245 |
Tub stool or bench |
32 |
25 |
$3K |
| A4259 |
Lancets, per box of 100 |
179 |
153 |
$2K |