| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
9,362 |
9,313 |
$1.15M |
| A4554 |
Disposable underpads |
24,418 |
24,223 |
$879K |
| T4526 |
Adult size pull-on med |
6,480 |
6,433 |
$713K |
| T4528 |
Adult size pull-on xl |
3,888 |
3,858 |
$593K |
| T4535 |
Disposable liner/shield/pad |
9,451 |
9,298 |
$261K |
| T4523 |
Adult size brief/diaper lg |
2,045 |
2,036 |
$205K |
| T4524 |
Adult size brief/diaper xl |
1,173 |
1,154 |
$144K |
| A4335 |
Incontinence supply |
25,929 |
25,747 |
$137K |
| A6533 |
Gc stocking thighlngth 18-30 |
381 |
212 |
$82K |
| T4534 |
Youth size pull-on |
531 |
523 |
$59K |
| A6250 |
Skin seal protect moisturizr |
5,819 |
5,801 |
$32K |
| T4544 |
Adlt disp und/pull on abv xl |
209 |
204 |
$32K |
| T4522 |
Adult size brief/diaper med |
315 |
313 |
$31K |
| A6530 |
Compression stocking bk18-30 |
61 |
32 |
$8K |
| T4530 |
Ped size brief/diaper lg |
25 |
25 |
$2K |
| A4670 |
Automatic bp monitor, dial |
27 |
25 |
$1K |
| T4525 |
Adult size pull-on sm |
12 |
12 |
$985.24 |