| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
787 |
681 |
$36K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
398 |
352 |
$21K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
168 |
141 |
$7K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12 |
12 |
$971.45 |
| 90662 |
|
497 |
497 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
232 |
232 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
17 |
17 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |