| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A5120 |
Skin barrier, wipe or swab |
77,443 |
30,960 |
$6.01M |
| T4532 |
Ped size pull-on lg |
34,685 |
32,761 |
$4.08M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
28,708 |
21,090 |
$3.52M |
| T4531 |
Ped size pull-on sm/med |
24,082 |
22,528 |
$2.69M |
| B4150 |
Ef complet w/intact nutrient |
11,503 |
8,242 |
$1.30M |
| B4100 |
Food thickener oral |
8,502 |
5,105 |
$634K |
| T4530 |
Ped size brief/diaper lg |
5,629 |
5,211 |
$588K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,353 |
2,080 |
$427K |
| T4535 |
Disposable liner/shield/pad |
4,526 |
4,199 |
$359K |
| T4526 |
Adult size pull-on med |
3,382 |
3,163 |
$349K |
| T4527 |
Adult size pull-on lg |
2,928 |
2,739 |
$322K |
| A4927 |
Non-sterile gloves |
10,754 |
9,990 |
$268K |
| T4528 |
Adult size pull-on xl |
1,507 |
1,391 |
$151K |
| T4522 |
Adult size brief/diaper med |
1,031 |
978 |
$112K |
| A4554 |
Disposable underpads |
797 |
756 |
$50K |
| B4161 |
Ef ped hydrolyzed/amino acid |
132 |
90 |
$29K |
| T4525 |
Adult size pull-on sm |
176 |
173 |
$18K |
| T4543 |
Adult disp brief/diap abv xl |
102 |
99 |
$10K |
| T4529 |
Ped size brief/diaper sm/med |
14 |
12 |
$1K |