| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
357 |
331 |
$13K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
113 |
107 |
$1K |
| T4541 |
Incontinence product, disposable underpad, large, each |
180 |
171 |
$399.00 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
110 |
104 |
$196.68 |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
27 |
27 |
$49.28 |