| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
855 |
855 |
$68K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
208 |
208 |
$25K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
824 |
824 |
$22K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
613 |
613 |
$21K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
209 |
208 |
$20K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
147 |
147 |
$19K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
313 |
313 |
$12K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
500 |
500 |
$7K |
| A4927 |
Gloves, non-sterile, per 100 |
755 |
754 |
$3K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
47 |
47 |
$3K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
22 |
22 |
$2K |