| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X1939 |
|
4,495 |
4,475 |
$272K |
| A4554 |
Disposable underpads, all sizes |
6,161 |
5,992 |
$201K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,967 |
1,871 |
$147K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,112 |
2,090 |
$106K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,994 |
1,767 |
$92K |
| T5999 |
Supply, not otherwise specified |
11,474 |
10,878 |
$78K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,769 |
1,757 |
$50K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
25 |
25 |
$3K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
24 |
24 |
$3K |
| E0570 |
Nebulizer, with compressor |
21 |
19 |
$2K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
24 |
24 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
23 |
23 |
$2K |