| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
1,192 |
1,117 |
$69K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
315 |
296 |
$54K |
| T4541 |
Incontinence product, disposable underpad, large, each |
585 |
543 |
$33K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
459 |
433 |
$30K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
533 |
499 |
$30K |
| A4927 |
Gloves, non-sterile, per 100 |
738 |
674 |
$17K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
979 |
492 |
$12K |
| A4335 |
Incontinence supply; miscellaneous |
840 |
473 |
$7K |