| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X1939 |
|
2,801 |
2,791 |
$163K |
| A4554 |
Disposable underpads, all sizes |
4,225 |
4,219 |
$134K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,408 |
2,404 |
$128K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,785 |
1,781 |
$128K |
| T5999 |
Supply, not otherwise specified |
10,097 |
10,069 |
$73K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,201 |
1,199 |
$34K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
664 |
660 |
$30K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
18 |
18 |
$3K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
24 |
24 |
$2K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
12 |
12 |
$1K |