| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X1939 |
|
1,468 |
1,459 |
$106K |
| A4554 |
Disposable underpads, all sizes |
2,676 |
2,628 |
$86K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
804 |
793 |
$54K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,549 |
1,537 |
$45K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
700 |
692 |
$36K |
| T5999 |
Supply, not otherwise specified |
4,908 |
4,842 |
$28K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
74 |
74 |
$10K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
23 |
23 |
$3K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
52 |
52 |
$3K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
17 |
17 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12 |
12 |
$819.20 |