| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
33,848 |
24,812 |
$2.66M |
| T4528 |
Adult size pull-on xl |
24,625 |
18,222 |
$2.06M |
| T4526 |
Adult size pull-on med |
27,831 |
20,592 |
$2.03M |
| A4554 |
Disposable underpads |
36,845 |
33,835 |
$1.80M |
| T4523 |
Adult size brief/diaper lg |
14,905 |
10,404 |
$1.16M |
| A4553 |
Nondisp underpads, all sizes |
6,084 |
5,756 |
$1.07M |
| T4522 |
Adult size brief/diaper med |
14,605 |
9,685 |
$1.05M |
| T4544 |
Adlt disp und/pull on abv xl |
10,378 |
7,572 |
$828K |
| T4524 |
Adult size brief/diaper xl |
9,735 |
6,589 |
$795K |
| T4525 |
Adult size pull-on sm |
10,393 |
7,718 |
$656K |
| T4534 |
Youth size pull-on |
9,455 |
6,613 |
$650K |
| T4521 |
Adult size brief/diaper sm |
3,819 |
2,652 |
$245K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,973 |
1,447 |
$220K |
| B4035 |
Enteral feed supp pump per d |
2,434 |
1,568 |
$197K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,126 |
2,045 |
$190K |
| B4150 |
Ef complet w/intact nutrient |
2,036 |
1,416 |
$184K |
| T4530 |
Ped size brief/diaper lg |
3,608 |
2,478 |
$167K |
| A4351 |
Straight tip urine catheter |
1,414 |
1,194 |
$79K |
| B4034 |
Enter feed supkit syr by day |
2,569 |
1,795 |
$77K |
| A6197 |
Alginate drsg >16 <=48 sq in |
239 |
212 |
$63K |
| A6260 |
Wound cleanser any type/size |
2,403 |
2,219 |
$51K |
| A4314 |
Cath w/drainage 2-way latex |
4,276 |
3,460 |
$37K |
| A4452 |
Waterproof tape |
3,450 |
2,763 |
$30K |
| A6446 |
Conform band s w>=3" <5"/yd |
911 |
808 |
$28K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
285 |
243 |
$22K |
| A4409 |
Ost skn barr convex <=4 sq i |
662 |
487 |
$15K |
| A4425 |
Ost pch drain for barrier fl |
700 |
522 |
$14K |
| A4322 |
Irrigation syringe |
495 |
462 |
$14K |
| A6216 |
Non-sterile gauze<=16 sq in |
1,861 |
1,602 |
$11K |
| A4357 |
Bedside drainage bag |
5,567 |
4,127 |
$10K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
333 |
249 |
$9K |
| A6196 |
Alginate dressing <=16 sq in |
82 |
65 |
$9K |
| A6403 |
Sterile gauze>16 <= 48 sq in |
801 |
686 |
$8K |
| A4358 |
Urinary leg or abdomen bag |
2,864 |
2,167 |
$8K |
| A6402 |
Sterile gauze <= 16 sq in |
1,547 |
1,225 |
$5K |
| A5120 |
Skin barrier, wipe or swab |
1,088 |
853 |
$5K |
| A4311 |
Catheter w/o bag 2-way latex |
862 |
682 |
$5K |
| B4100 |
Food thickener oral |
56 |
54 |
$4K |
| A4333 |
Urinary cath anchor device |
463 |
378 |
$4K |
| A4456 |
Adhesive remover, wipes |
757 |
566 |
$3K |
| A6212 |
Foam drg <=16 sq in w/border |
27 |
25 |
$2K |
| A4520 |
Incontinence garment anytype |
4,160 |
3,415 |
$2K |
| T4533 |
Youth size brief/diaper |
38 |
27 |
$2K |
| A5063 |
Drain ostomy pouch w/flange |
133 |
101 |
$2K |
| B4088 |
Gastro/jejuno tube, low-pro |
25 |
24 |
$2K |
| A4402 |
Lubricant per ounce |
602 |
416 |
$2K |
| A4334 |
Urinary cath leg strap |
1,412 |
1,176 |
$1K |
| A4385 |
Ost skn barrier sld ext wear |
52 |
37 |
$1K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
22 |
13 |
$487.40 |
| E0776 |
Iv pole |
16 |
13 |
$200.13 |
| A4371 |
Skin barrier powder per oz |
34 |
25 |
$69.94 |
| A4406 |
Pectin based ostomy paste |
15 |
12 |
$61.15 |
| A4450 |
Non-waterproof tape |
29 |
24 |
$37.51 |