| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,314 |
1,842 |
$265K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,891 |
1,428 |
$201K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,647 |
1,307 |
$185K |
| T4541 |
Incontinence product, disposable underpad, large, each |
4,081 |
3,133 |
$156K |
| A4927 |
Gloves, non-sterile, per 100 |
5,891 |
4,216 |
$89K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
344 |
289 |
$41K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
268 |
208 |
$31K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
198 |
161 |
$14K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,856 |
1,395 |
$9K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
25 |
13 |
$411.38 |
| A4259 |
Lancets, per box of 100 |
583 |
447 |
$332.87 |
| 90686 |
|
22 |
22 |
$0.00 |
| 0013A |
|
21 |
21 |
$0.00 |
| A4554 |
Disposable underpads, all sizes |
93 |
88 |
$0.00 |