| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
11,777 |
11,165 |
$1.63M |
| T4522 |
Adult size brief/diaper med |
10,620 |
9,919 |
$1.30M |
| T4527 |
Adult size pull-on lg |
13,425 |
12,801 |
$1.16M |
| T4528 |
Adult size pull-on xl |
9,447 |
8,951 |
$909K |
| T4526 |
Adult size pull-on med |
10,891 |
10,422 |
$907K |
| T4541 |
Large disposable underpad |
19,043 |
18,664 |
$806K |
| A4927 |
Non-sterile gloves |
21,711 |
21,095 |
$602K |
| T4543 |
Adult disp brief/diap abv xl |
1,867 |
1,777 |
$359K |
| T4535 |
Disposable liner/shield/pad |
6,275 |
5,911 |
$350K |
| T4524 |
Adult size brief/diaper xl |
2,197 |
2,102 |
$280K |
| T4544 |
Adlt disp und/pull on abv xl |
1,725 |
1,627 |
$223K |
| G9012 |
Other specified case mgmt |
10,189 |
8,119 |
$193K |
| B4100 |
Food thickener oral |
3,556 |
3,007 |
$142K |
| B4152 |
Ef calorie dense>/=1.5kcal |
827 |
734 |
$112K |
| B4150 |
Ef complet w/intact nutrient |
547 |
490 |
$90K |
| A4320 |
Irrigation tray |
376 |
360 |
$83K |
| T4525 |
Adult size pull-on sm |
833 |
808 |
$60K |
| A4351 |
Straight tip urine catheter |
257 |
225 |
$43K |
| A4357 |
Bedside drainage bag |
4,027 |
3,437 |
$42K |
| A4211 |
Supp for self-adm injections |
989 |
879 |
$34K |
| 99605 |
|
599 |
598 |
$23K |
| J7626 |
Budesonide non-comp unit |
1,178 |
1,139 |
$20K |
| A4253 |
Blood glucose/reagent strips |
1,632 |
1,474 |
$17K |
| A4217 |
Sterile water/saline, 500 ml |
273 |
259 |
$13K |
| Q0513 |
Disp fee inhal drugs/30 days |
2,040 |
1,921 |
$12K |
| 99607 |
|
414 |
412 |
$11K |
| A4358 |
Urinary leg or abdomen bag |
1,222 |
1,091 |
$9K |
| A4349 |
Disposable male external cat |
211 |
191 |
$8K |
| T2029 |
Special med equip, noswaiver |
397 |
304 |
$7K |
| 0012A |
|
1,681 |
1,665 |
$5K |
| B9998 |
Enteral supp not otherwise c |
75 |
66 |
$4K |
| 0011A |
|
1,636 |
1,627 |
$4K |
| A6402 |
Sterile gauze <= 16 sq in |
717 |
652 |
$3K |
| A4314 |
Cath w/drainage 2-way latex |
226 |
198 |
$2K |
| A4310 |
Insert tray w/o bag/cath |
153 |
147 |
$2K |
| A4245 |
Alcohol wipes per box |
234 |
226 |
$901.67 |
| A4338 |
Indwelling catheter latex |
47 |
42 |
$739.46 |
| J7620 |
Albuterol ipratrop non-comp |
198 |
192 |
$541.02 |
| A4259 |
Lancets per box |
123 |
119 |
$175.90 |
| J7613 |
Albuterol non-comp unit |
130 |
110 |
$146.63 |
| A9270 |
Non-covered item or service |
1,530 |
898 |
$0.00 |
| 90686 |
|
160 |
160 |
$0.00 |
| E0607 |
Blood glucose monitor home |
25 |
25 |
$0.00 |
| A4322 |
Irrigation syringe |
25 |
12 |
$0.00 |