| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
387 |
380 |
$8K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
514 |
496 |
$6K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,923 |
1,868 |
$6K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
269 |
265 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
1,672 |
1,624 |
$4K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
71 |
68 |
$0.00 |