| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads |
50,389 |
46,300 |
$1.86M |
| T4527 |
Adult size pull-on lg |
11,321 |
10,466 |
$1.16M |
| T4528 |
Adult size pull-on xl |
9,898 |
9,126 |
$1.04M |
| T4523 |
Adult size brief/diaper lg |
8,779 |
8,040 |
$862K |
| T4543 |
Adult disp brief/diap abv xl |
4,220 |
3,764 |
$764K |
| T4524 |
Adult size brief/diaper xl |
6,870 |
6,400 |
$697K |
| T4526 |
Adult size pull-on med |
8,306 |
7,673 |
$654K |
| A4351 |
Straight tip urine catheter |
2,535 |
2,311 |
$586K |
| A6250 |
Skin seal protect moisturizr |
58,268 |
54,278 |
$575K |
| T4544 |
Adlt disp und/pull on abv xl |
4,659 |
4,271 |
$499K |
| A4927 |
Non-sterile gloves |
14,094 |
12,369 |
$407K |
| A9999 |
Dme supply or accessory, nos |
13,511 |
11,894 |
$392K |
| T4522 |
Adult size brief/diaper med |
4,125 |
3,763 |
$328K |
| A4349 |
Disposable male external cat |
2,973 |
2,624 |
$110K |
| T4525 |
Adult size pull-on sm |
906 |
825 |
$65K |
| A4357 |
Bedside drainage bag |
4,181 |
3,727 |
$43K |
| A6219 |
Gauze <= 16 sq in w/border |
582 |
562 |
$34K |
| A4358 |
Urinary leg or abdomen bag |
3,913 |
3,502 |
$33K |
| A4456 |
Adhesive remover, wipes |
653 |
618 |
$8K |
| A4331 |
Extension drainage tubing |
2,336 |
2,153 |
$7K |
| A4335 |
Incontinence supply |
301 |
293 |
$6K |
| A6216 |
Non-sterile gauze<=16 sq in |
647 |
625 |
$5K |
| A4450 |
Non-waterproof tape |
618 |
602 |
$5K |
| A4660 |
Sphyg/bp app w cuff and stet |
140 |
137 |
$3K |
| A4244 |
Alcohol or peroxide per pint |
493 |
477 |
$3K |
| A4402 |
Lubricant per ounce |
58 |
50 |
$632.61 |
| A4338 |
Indwelling catheter latex |
62 |
48 |
$376.26 |
| A4253 |
Blood glucose/reagent strips |
14 |
12 |
$309.41 |
| A5120 |
Skin barrier, wipe or swab |
25 |
25 |
$288.00 |
| A4245 |
Alcohol wipes per box |
13 |
13 |
$29.50 |