| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5199 |
Personal care item, nos, each |
4,955 |
4,767 |
$332K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,272 |
1,250 |
$156K |
| A4554 |
Disposable underpads, all sizes |
3,292 |
3,190 |
$136K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
891 |
869 |
$130K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,004 |
939 |
$103K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
929 |
903 |
$97K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
421 |
410 |
$62K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
77 |
76 |
$9K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
12 |
12 |
$381.04 |