| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,468 |
1,406 |
$188K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
856 |
826 |
$144K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
762 |
726 |
$88K |
| A4927 |
Gloves, non-sterile, per 100 |
1,644 |
1,521 |
$87K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
807 |
735 |
$40K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
273 |
269 |
$14K |
| T4541 |
Incontinence product, disposable underpad, large, each |
296 |
280 |
$10K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
26 |
25 |
$1K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
26 |
25 |
$81.55 |