| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
2,237 |
2,220 |
$93K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
775 |
771 |
$75K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
843 |
839 |
$68K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
563 |
559 |
$28K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
189 |
186 |
$16K |
| A4927 |
Gloves, non-sterile, per 100 |
701 |
695 |
$7K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
283 |
281 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
306 |
304 |
$2K |
| J3490 |
Unclassified drugs |
458 |
443 |
$0.00 |