| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5199 |
Personal care item nos each |
18,422 |
17,229 |
$1.06M |
| T4527 |
Adult size pull-on lg |
5,430 |
5,192 |
$557K |
| T4526 |
Adult size pull-on med |
5,773 |
5,507 |
$542K |
| A4554 |
Disposable underpads |
13,724 |
12,982 |
$486K |
| T4528 |
Adult size pull-on xl |
3,564 |
3,419 |
$420K |
| T4522 |
Adult size brief/diaper med |
4,531 |
4,314 |
$391K |
| T4523 |
Adult size brief/diaper lg |
2,713 |
2,575 |
$273K |
| A4927 |
Non-sterile gloves |
19,703 |
16,615 |
$233K |
| T4534 |
Youth size pull-on |
1,853 |
1,756 |
$176K |
| B4150 |
Ef complet w/intact nutrient |
1,012 |
782 |
$137K |
| T4525 |
Adult size pull-on sm |
1,600 |
1,528 |
$135K |
| T4535 |
Disposable liner/shield/pad |
4,869 |
4,590 |
$122K |
| T4521 |
Adult size brief/diaper sm |
1,337 |
1,248 |
$110K |
| T4524 |
Adult size brief/diaper xl |
1,025 |
966 |
$95K |
| T4543 |
Adult disp brief/diap abv xl |
369 |
344 |
$55K |
| T4544 |
Adlt disp und/pull on abv xl |
428 |
398 |
$52K |
| T4533 |
Youth size brief/diaper |
286 |
269 |
$23K |