| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
236 |
236 |
$29K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
193 |
192 |
$28K |
| A4554 |
Disposable underpads, all sizes |
606 |
603 |
$25K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
134 |
134 |
$21K |
| A4335 |
Incontinence supply; miscellaneous |
718 |
714 |
$4K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
307 |
304 |
$1K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
157 |
157 |
$1K |