| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
283 |
283 |
$31K |
| A4554 |
Disposable underpads, all sizes |
477 |
476 |
$20K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
395 |
392 |
$19K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
325 |
324 |
$11K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
369 |
366 |
$10K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
56 |
56 |
$4K |
| A5120 |
Skin barrier, wipes or swabs, each |
27 |
27 |
$523.88 |
| A4927 |
Gloves, non-sterile, per 100 |
36 |
36 |
$160.84 |