| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,351 |
922 |
$113K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,198 |
800 |
$82K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
652 |
456 |
$53K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
611 |
408 |
$49K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
474 |
333 |
$47K |
| A4554 |
Disposable underpads, all sizes |
1,300 |
911 |
$34K |
| A4927 |
Gloves, non-sterile, per 100 |
424 |
302 |
$6K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
74 |
53 |
$5K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
17 |
13 |
$2K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13 |
13 |
$1K |