| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
1,130 |
1,129 |
$63K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
83 |
83 |
$6K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
22 |
18 |
$1K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
17 |
16 |
$1K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
14 |
14 |
$697.12 |
| A4927 |
Gloves, non-sterile, per 100 |
37 |
35 |
$412.06 |