| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
9,783 |
9,771 |
$684K |
| A4554 |
Disposable underpads, all sizes |
21,012 |
20,960 |
$580K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
7,174 |
7,167 |
$523K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
13,683 |
13,668 |
$365K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,432 |
1,429 |
$173K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,743 |
2,739 |
$136K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
1,265 |
1,114 |
$126K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
2,369 |
2,363 |
$63K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,950 |
1,935 |
$56K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
511 |
463 |
$34K |
| A4927 |
Gloves, non-sterile, per 100 |
1,433 |
1,424 |
$6K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
51 |
42 |
$4K |
| A4402 |
Lubricant, per ounce |
24 |
24 |
$138.65 |