| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
692 |
688 |
$110K |
| A4554 |
Disposable underpads, all sizes |
2,916 |
2,886 |
$99K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
441 |
432 |
$86K |
| A4335 |
Incontinence supply; miscellaneous |
3,324 |
3,300 |
$17K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
2,042 |
2,017 |
$9K |
| A4927 |
Gloves, non-sterile, per 100 |
58 |
56 |
$365.78 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
12 |
12 |
$300.34 |