| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
838 |
807 |
$141K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
245 |
176 |
$75K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,168 |
1,129 |
$53K |
| A4927 |
Gloves, non-sterile, per 100 |
1,898 |
1,757 |
$39K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
130 |
111 |
$29K |
| A4554 |
Disposable underpads, all sizes |
248 |
180 |
$18K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
37 |
37 |
$5K |
| A5120 |
Skin barrier, wipes or swabs, each |
32 |
31 |
$341.00 |