| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
13,794 |
13,575 |
$2.14M |
| T4543 |
Adult disp brief/diap abv xl |
4,393 |
4,249 |
$1.58M |
| T4527 |
Adult size pull-on lg |
11,290 |
11,068 |
$1.57M |
| A4927 |
Non-sterile gloves |
71,816 |
67,522 |
$1.41M |
| T4526 |
Adult size pull-on med |
10,142 |
9,921 |
$1.21M |
| T4528 |
Adult size pull-on xl |
7,221 |
6,981 |
$923K |
| T4522 |
Adult size brief/diaper med |
6,269 |
6,030 |
$908K |
| T4524 |
Adult size brief/diaper xl |
5,548 |
5,431 |
$871K |
| T4534 |
Youth size pull-on |
5,281 |
5,104 |
$838K |
| T4537 |
Reusable underpad bed size |
21,337 |
21,071 |
$813K |
| B4035 |
Enteral feed supp pump per d |
3,192 |
2,814 |
$742K |
| T4541 |
Large disposable underpad |
29,252 |
28,565 |
$648K |
| T4535 |
Disposable liner/shield/pad |
12,362 |
12,118 |
$459K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,317 |
1,277 |
$423K |
| B4150 |
Ef complet w/intact nutrient |
1,661 |
1,596 |
$304K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,646 |
1,524 |
$296K |
| B4100 |
Food thickener oral |
5,798 |
5,635 |
$261K |
| B9998 |
Enteral supp not otherwise c |
1,864 |
1,588 |
$244K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,575 |
1,527 |
$134K |
| B4153 |
Ef hydrolyzed/amino acids |
204 |
190 |
$129K |
| T4525 |
Adult size pull-on sm |
894 |
863 |
$128K |
| T4544 |
Adlt disp und/pull on abv xl |
637 |
618 |
$106K |
| A4322 |
Irrigation syringe |
3,211 |
2,921 |
$106K |
| B9002 |
Enter nutr inf pump any type |
1,625 |
1,553 |
$92K |
| T4530 |
Ped size brief/diaper lg |
738 |
710 |
$61K |
| T4521 |
Adult size brief/diaper sm |
363 |
359 |
$55K |
| A4520 |
Incontinence garment anytype |
732 |
693 |
$30K |
| B4034 |
Enter feed supkit syr by day |
243 |
203 |
$28K |
| B4154 |
Ef spec metabolic noninherit |
99 |
94 |
$26K |
| A4253 |
Blood glucose/reagent strips |
924 |
840 |
$25K |
| A4554 |
Disposable underpads |
1,129 |
1,099 |
$21K |
| A4553 |
Nondisp underpads, all sizes |
462 |
446 |
$14K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
28 |
27 |
$7K |
| A4259 |
Lancets per box |
631 |
580 |
$7K |
| B4155 |
Ef incomplete/modular |
67 |
61 |
$5K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
79 |
66 |
$4K |
| T4532 |
Ped size pull-on lg |
26 |
25 |
$3K |
| A4357 |
Bedside drainage bag |
380 |
331 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
422 |
392 |
$2K |
| A4320 |
Irrigation tray |
150 |
119 |
$1K |
| A7003 |
Nebulizer administration set |
576 |
547 |
$1K |
| A4338 |
Indwelling catheter latex |
58 |
50 |
$283.54 |
| A4310 |
Insert tray w/o bag/cath |
45 |
38 |
$67.11 |