| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
1,707 |
1,705 |
$95K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
682 |
679 |
$68K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,349 |
1,345 |
$45K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,343 |
1,340 |
$41K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
1,178 |
1,172 |
$39K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
1,037 |
1,036 |
$17K |
| A4927 |
Gloves, non-sterile, per 100 |
336 |
336 |
$2K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$1K |