| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4335 |
Incontinence supply; miscellaneous |
1,497 |
1,404 |
$80K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
190 |
173 |
$15K |
| A4927 |
Gloves, non-sterile, per 100 |
109 |
50 |
$7K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
66 |
51 |
$4K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
46 |
46 |
$3K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
24 |
18 |
$390.60 |