| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads |
3,610 |
1,835 |
$128K |
| A4335 |
Incontinence supply |
4,978 |
3,799 |
$111K |
| A6250 |
Skin seal protect moisturizr |
5,843 |
3,969 |
$86K |
| T4524 |
Adult size brief/diaper xl |
991 |
536 |
$68K |
| T4523 |
Adult size brief/diaper lg |
1,043 |
558 |
$67K |
| A4927 |
Non-sterile gloves |
6,316 |
4,001 |
$65K |
| A9999 |
Dme supply or accessory, nos |
2,294 |
1,808 |
$64K |
| T4543 |
Adult disp brief/diap abv xl |
407 |
200 |
$39K |
| T4522 |
Adult size brief/diaper med |
762 |
384 |
$33K |
| T4527 |
Adult size pull-on lg |
122 |
113 |
$16K |
| T4533 |
Youth size brief/diaper |
302 |
156 |
$11K |
| T4528 |
Adult size pull-on xl |
90 |
77 |
$10K |
| A4351 |
Straight tip urine catheter |
79 |
41 |
$9K |
| T4526 |
Adult size pull-on med |
71 |
61 |
$6K |
| T4529 |
Ped size brief/diaper sm/med |
57 |
26 |
$2K |