| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
93 |
75 |
$8K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
67 |
65 |
$7K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
28 |
24 |
$3K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
13 |
12 |
$2K |
| B4100 |
Food thickener, administered orally, per ounce |
43 |
37 |
$2K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
13 |
12 |
$1K |