| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,872 |
4,685 |
$927K |
| T4541 |
Incontinence product, disposable underpad, large, each |
4,449 |
4,264 |
$262K |
| A4927 |
Gloves, non-sterile, per 100 |
7,718 |
7,429 |
$220K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,007 |
2,899 |
$213K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
198 |
189 |
$55K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
170 |
168 |
$33K |
| S5199 |
Personal care item, nos, each |
324 |
321 |
$22K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
249 |
236 |
$13K |
| A4554 |
Disposable underpads, all sizes |
134 |
128 |
$10K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
12 |
12 |
$2K |
| A4245 |
Alcohol wipes, per box |
25 |
25 |
$621.90 |