| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult size brief/diaper xl |
3,279 |
2,881 |
$538K |
| T4543 |
Adult disp brief/diap abv xl |
2,080 |
1,855 |
$521K |
| A4554 |
Disposable underpads |
8,722 |
7,750 |
$445K |
| T4535 |
Disposable liner/shield/pad |
5,606 |
4,981 |
$346K |
| A6250 |
Skin seal protect moisturizr |
7,073 |
6,209 |
$238K |
| A4927 |
Non-sterile gloves |
9,409 |
8,360 |
$212K |
| T4523 |
Adult size brief/diaper lg |
1,316 |
1,184 |
$206K |
| A5120 |
Skin barrier, wipe or swab |
9,205 |
8,196 |
$94K |
| T4522 |
Adult size brief/diaper med |
619 |
546 |
$68K |
| A6208 |
Contact layer > 48 sq in |
69 |
65 |
$9K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
71 |
66 |
$7K |
| A6260 |
Wound cleanser any type/size |
74 |
69 |
$5K |
| S5199 |
Personal care item nos each |
103 |
97 |
$5K |
| A4217 |
Sterile water/saline, 500 ml |
16 |
14 |
$2K |
| A4670 |
Automatic bp monitor, dial |
16 |
12 |
$631.79 |