| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X1939 |
|
10,418 |
10,353 |
$655K |
| A4554 |
Disposable underpads, all sizes |
18,974 |
18,776 |
$613K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
5,945 |
5,847 |
$390K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
3,039 |
2,979 |
$388K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
6,103 |
5,962 |
$315K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
10,422 |
10,361 |
$298K |
| T5999 |
Supply, not otherwise specified |
39,994 |
39,180 |
$264K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,597 |
4,550 |
$210K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,645 |
1,618 |
$180K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,674 |
1,654 |
$90K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
1,094 |
1,031 |
$53K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
806 |
776 |
$51K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
396 |
385 |
$40K |
| E0244 |
Raised toilet seat |
364 |
350 |
$36K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
216 |
212 |
$20K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
119 |
118 |
$8K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
42 |
42 |
$3K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
15 |
15 |
$2K |