| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
745 |
740 |
$79K |
| A4554 |
Disposable underpads, all sizes |
1,639 |
1,638 |
$65K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,039 |
1,036 |
$42K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
246 |
246 |
$32K |
| A4335 |
Incontinence supply; miscellaneous |
2,535 |
2,532 |
$14K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
24 |
24 |
$2K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
12 |
12 |
$365.22 |