| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,036 |
1,955 |
$191K |
| A4927 |
Gloves, non-sterile, per 100 |
6,510 |
6,247 |
$112K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
935 |
895 |
$71K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,768 |
1,697 |
$56K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,839 |
1,773 |
$55K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,042 |
1,026 |
$46K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
900 |
847 |
$37K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
357 |
356 |
$33K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
13 |
12 |
$735.55 |