| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,075 |
1,041 |
$193K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,071 |
1,051 |
$157K |
| A4554 |
Disposable underpads, all sizes |
3,495 |
3,430 |
$128K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
832 |
815 |
$26K |
| A4335 |
Incontinence supply; miscellaneous |
3,471 |
3,402 |
$17K |
| A4927 |
Gloves, non-sterile, per 100 |
12 |
12 |
$93.36 |