| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
3,279 |
2,881 |
$538K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
2,080 |
1,855 |
$521K |
| A4554 |
Disposable underpads, all sizes |
8,722 |
7,750 |
$445K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,606 |
4,981 |
$346K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
7,073 |
6,209 |
$238K |
| A4927 |
Gloves, non-sterile, per 100 |
9,409 |
8,360 |
$212K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,316 |
1,184 |
$206K |
| A5120 |
Skin barrier, wipes or swabs, each |
9,205 |
8,196 |
$94K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
619 |
546 |
$68K |
| A6208 |
Contact layer, sterile, more than 48 sq. in., each dressing |
69 |
65 |
$9K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
71 |
66 |
$7K |
| A6260 |
Wound cleansers, any type, any size |
74 |
69 |
$5K |
| S5199 |
Personal care item, nos, each |
103 |
97 |
$5K |
| A4217 |
Sterile water/saline, 500 ml |
16 |
14 |
$2K |
| A4670 |
Automatic blood pressure monitor |
16 |
12 |
$631.79 |