| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
33,182 |
30,468 |
$1.12M |
| X1939 |
|
11,606 |
11,579 |
$758K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
3,545 |
3,139 |
$476K |
| T5999 |
Supply, not otherwise specified |
54,112 |
45,100 |
$474K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
8,108 |
7,385 |
$435K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
6,198 |
5,754 |
$425K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
7,979 |
7,325 |
$393K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
3,563 |
2,861 |
$269K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,293 |
2,044 |
$233K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,831 |
1,749 |
$223K |
| X1922 |
|
1,582 |
1,314 |
$216K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
2,539 |
2,265 |
$201K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,488 |
2,070 |
$174K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,437 |
4,276 |
$134K |
| A4927 |
Gloves, non-sterile, per 100 |
6,462 |
6,352 |
$118K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,695 |
1,526 |
$90K |
| X1915 |
|
851 |
681 |
$66K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
63 |
62 |
$9K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
15 |
14 |
$1K |