| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
2,108 |
2,048 |
$354K |
| A4927 |
Non-sterile gloves |
10,593 |
9,391 |
$257K |
| T4528 |
Adult size pull-on xl |
1,849 |
1,768 |
$246K |
| T4527 |
Adult size pull-on lg |
1,645 |
1,586 |
$212K |
| T4526 |
Adult size pull-on med |
1,300 |
1,227 |
$135K |
| T4541 |
Large disposable underpad |
1,821 |
1,809 |
$103K |
| T4522 |
Adult size brief/diaper med |
589 |
554 |
$86K |
| T4524 |
Adult size brief/diaper xl |
304 |
290 |
$56K |
| T4535 |
Disposable liner/shield/pad |
1,809 |
1,742 |
$47K |
| A4554 |
Disposable underpads |
1,769 |
1,654 |
$39K |
| T4537 |
Reusable underpad bed size |
650 |
609 |
$33K |
| B4150 |
Ef complet w/intact nutrient |
232 |
154 |
$19K |
| A4553 |
Nondisp underpads, all sizes |
91 |
86 |
$7K |
| A4520 |
Incontinence garment anytype |
12 |
12 |
$0.00 |