| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
4,124 |
4,055 |
$143K |
| X1939 |
|
1,668 |
1,631 |
$104K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,280 |
1,260 |
$97K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,599 |
1,574 |
$92K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,911 |
1,882 |
$59K |
| T5999 |
Supply, not otherwise specified |
8,684 |
8,653 |
$54K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,007 |
993 |
$49K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
50 |
50 |
$7K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
36 |
36 |
$6K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
41 |
41 |
$5K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
33 |
33 |
$3K |