| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,695 |
3,431 |
$303K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
4,576 |
2,789 |
$172K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,477 |
1,078 |
$127K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
3,612 |
2,681 |
$118K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,630 |
1,111 |
$112K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,214 |
859 |
$100K |
| A4927 |
Gloves, non-sterile, per 100 |
5,526 |
4,131 |
$86K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,885 |
1,339 |
$56K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
52 |
36 |
$7K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
23 |
12 |
$1K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
80 |
34 |
$963.23 |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
29 |
26 |
$672.50 |