| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,212 |
1,018 |
$71K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,175 |
1,882 |
$69K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
666 |
612 |
$62K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
838 |
715 |
$55K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
350 |
280 |
$38K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
570 |
459 |
$33K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
811 |
709 |
$22K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
224 |
207 |
$12K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
122 |
117 |
$11K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
99 |
86 |
$5K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
55 |
51 |
$5K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$2K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
12 |
12 |
$2K |
| A4452 |
Tape, waterproof, per 18 square inches |
130 |
127 |
$2K |
| A5120 |
Skin barrier, wipes or swabs, each |
335 |
312 |
$2K |
| A4456 |
Adhesive remover, wipes, any type, each |
136 |
132 |
$2K |
| A4670 |
Automatic blood pressure monitor |
33 |
24 |
$1K |
| E0570 |
Nebulizer, with compressor |
14 |
12 |
$868.72 |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
13 |
12 |
$596.81 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
13 |
12 |
$248.14 |