| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
12,625 |
12,577 |
$462K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,814 |
3,722 |
$413K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
11,742 |
9,798 |
$388K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,133 |
3,570 |
$371K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,734 |
2,260 |
$282K |
| A4335 |
Incontinence supply; miscellaneous |
15,458 |
15,402 |
$85K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
243 |
151 |
$15K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
32 |
24 |
$4K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
75 |
65 |
$3K |
| A4259 |
Lancets, per box of 100 |
26 |
26 |
$245.43 |
| A4245 |
Alcohol wipes, per box |
65 |
65 |
$104.00 |