| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
121 |
119 |
$13K |
| A4927 |
Gloves, non-sterile, per 100 |
375 |
365 |
$7K |
| T4541 |
Incontinence product, disposable underpad, large, each |
138 |
137 |
$6K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
165 |
149 |
$6K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
62 |
62 |
$5K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
75 |
69 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
15 |
13 |
$1K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
14 |
14 |
$1K |