| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
40,791 |
36,938 |
$1.44M |
| A4927 |
Non-sterile gloves |
88,598 |
79,604 |
$1.30M |
| T4526 |
Adult size pull-on med |
10,973 |
9,929 |
$968K |
| T4528 |
Adult size pull-on xl |
8,505 |
7,662 |
$835K |
| T4527 |
Adult size pull-on lg |
9,212 |
8,251 |
$825K |
| T4535 |
Disposable liner/shield/pad |
18,531 |
16,792 |
$817K |
| T4544 |
Adlt disp und/pull on abv xl |
3,180 |
2,792 |
$722K |
| T4537 |
Reusable underpad bed size |
6,542 |
5,962 |
$650K |
| T4543 |
Adult disp brief/diap abv xl |
2,629 |
2,356 |
$608K |
| T4522 |
Adult size brief/diaper med |
5,117 |
4,464 |
$495K |
| T4534 |
Youth size pull-on |
4,890 |
4,620 |
$472K |
| B4150 |
Ef complet w/intact nutrient |
3,841 |
3,224 |
$448K |
| T4525 |
Adult size pull-on sm |
4,867 |
4,417 |
$439K |
| T4523 |
Adult size brief/diaper lg |
4,105 |
3,581 |
$438K |
| T4540 |
Reusable underpad chair size |
6,516 |
5,942 |
$327K |
| T4524 |
Adult size brief/diaper xl |
2,498 |
2,213 |
$295K |
| T4533 |
Youth size brief/diaper |
2,845 |
2,613 |
$278K |
| B4100 |
Food thickener oral |
1,374 |
1,143 |
$254K |
| T4521 |
Adult size brief/diaper sm |
2,180 |
1,918 |
$209K |
| A4358 |
Urinary leg or abdomen bag |
1,868 |
1,176 |
$14K |
| T2029 |
Special med equip, noswaiver |
215 |
197 |
$9K |
| A4357 |
Bedside drainage bag |
1,556 |
1,401 |
$8K |
| A4351 |
Straight tip urine catheter |
119 |
114 |
$7K |
| A4670 |
Automatic bp monitor, dial |
117 |
109 |
$5K |
| A4253 |
Blood glucose/reagent strips |
692 |
501 |
$3K |
| A4402 |
Lubricant per ounce |
748 |
674 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
96 |
96 |
$1K |
| A5120 |
Skin barrier, wipe or swab |
290 |
274 |
$1K |
| T4530 |
Ped size brief/diaper lg |
13 |
12 |
$1K |
| A4331 |
Extension drainage tubing |
209 |
191 |
$556.74 |
| A4259 |
Lancets per box |
693 |
501 |
$211.80 |
| A7003 |
Nebulizer administration set |
78 |
62 |
$168.59 |
| A4385 |
Ost skn barrier sld ext wear |
13 |
12 |
$120.00 |
| A4334 |
Urinary cath leg strap |
73 |
63 |
$78.00 |