| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,331 |
1,119 |
$171K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
555 |
446 |
$67K |
| A4554 |
Disposable underpads, all sizes |
999 |
843 |
$57K |
| A4245 |
Alcohol wipes, per box |
1,185 |
949 |
$45K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
234 |
203 |
$31K |
| A4927 |
Gloves, non-sterile, per 100 |
848 |
731 |
$14K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
91 |
84 |
$8K |