| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,185 |
1,178 |
$114K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,244 |
1,236 |
$58K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
369 |
359 |
$35K |
| A4927 |
Gloves, non-sterile, per 100 |
928 |
920 |
$23K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
383 |
250 |
$14K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
299 |
295 |
$13K |
| A4670 |
Automatic blood pressure monitor |
25 |
25 |
$2K |