| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,833 |
1,679 |
$125K |
| A4554 |
Disposable underpads, all sizes |
5,977 |
5,626 |
$122K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,330 |
3,965 |
$118K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,735 |
1,607 |
$109K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
833 |
813 |
$81K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
629 |
553 |
$69K |
| A4335 |
Incontinence supply; miscellaneous |
8,236 |
7,705 |
$32K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,557 |
943 |
$19K |
| A4259 |
Lancets, per box of 100 |
832 |
554 |
$2K |
| T4541 |
Incontinence product, disposable underpad, large, each |
12 |
12 |
$136.42 |
| A4927 |
Gloves, non-sterile, per 100 |
13 |
13 |
$18.67 |
| A9270 |
Non-covered item or service |
49 |
49 |
$0.00 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
86 |
85 |
$0.00 |