| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
37,564 |
37,544 |
$1.72M |
| T4535 |
Disposable liner/shield/pad |
35,769 |
35,747 |
$1.69M |
| T4527 |
Adult size pull-on lg |
12,413 |
12,407 |
$555K |
| A6250 |
Skin seal protect moisturizr |
29,379 |
29,369 |
$417K |
| T4536 |
Reusable pull-on any size |
34,791 |
34,774 |
$378K |
| A4335 |
Incontinence supply |
32,587 |
32,570 |
$233K |
| T4526 |
Adult size pull-on med |
5,608 |
5,606 |
$216K |
| T4523 |
Adult size brief/diaper lg |
4,684 |
4,678 |
$210K |
| T4528 |
Adult size pull-on xl |
1,946 |
1,945 |
$74K |
| A4927 |
Non-sterile gloves |
8,124 |
8,122 |
$54K |
| T4525 |
Adult size pull-on sm |
448 |
448 |
$18K |
| T4537 |
Reusable underpad bed size |
643 |
643 |
$18K |
| A4253 |
Blood glucose/reagent strips |
1,898 |
1,797 |
$15K |
| T4522 |
Adult size brief/diaper med |
215 |
215 |
$12K |
| A4259 |
Lancets per box |
1,899 |
1,797 |
$1K |
| E0607 |
Blood glucose monitor home |
105 |
105 |
$17.77 |
| L8000 |
Mastectomy bra |
18 |
16 |
$0.00 |