| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
976 |
954 |
$138K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,169 |
2,132 |
$127K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,851 |
1,825 |
$82K |
| A4927 |
Gloves, non-sterile, per 100 |
1,697 |
1,672 |
$28K |
| T4541 |
Incontinence product, disposable underpad, large, each |
572 |
564 |
$23K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
75 |
75 |
$12K |
| A4553 |
Non-disposable underpads, all sizes |
26 |
25 |
$401.50 |