| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
567 |
529 |
$56K |
| T4541 |
Incontinence product, disposable underpad, large, each |
944 |
877 |
$34K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
577 |
535 |
$19K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
75 |
70 |
$6K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
69 |
63 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
329 |
306 |
$5K |
| A4670 |
Automatic blood pressure monitor |
28 |
28 |
$1K |