| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
1,403 |
1,357 |
$68K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
398 |
395 |
$35K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
232 |
230 |
$16K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
92 |
90 |
$8K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
70 |
70 |
$5K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
41 |
39 |
$3K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
26 |
25 |
$2K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
15 |
14 |
$811.08 |
| 90662 |
|
13 |
13 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
27 |
27 |
$0.00 |
| 90674 |
|
13 |
13 |
$0.00 |