| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
50,371 |
47,775 |
$3.16M |
| T4527 |
Adult size pull-on lg |
19,419 |
18,456 |
$2.89M |
| T4526 |
Adult size pull-on med |
17,790 |
16,784 |
$2.62M |
| T4528 |
Adult size pull-on xl |
16,879 |
15,974 |
$2.41M |
| T4541 |
Large disposable underpad |
54,328 |
51,386 |
$1.81M |
| A4927 |
Non-sterile gloves |
65,295 |
61,767 |
$1.76M |
| A4554 |
Disposable underpads |
40,141 |
38,074 |
$1.12M |
| A4553 |
Nondisp underpads, all sizes |
48,063 |
45,545 |
$738K |
| T4524 |
Adult size brief/diaper xl |
4,158 |
3,970 |
$571K |
| T4543 |
Adult disp brief/diap abv xl |
2,099 |
1,994 |
$472K |
| T4523 |
Adult size brief/diaper lg |
3,540 |
3,351 |
$422K |
| T4536 |
Reusable pull-on any size |
6,642 |
6,317 |
$397K |
| T4525 |
Adult size pull-on sm |
1,401 |
1,347 |
$201K |
| T4522 |
Adult size brief/diaper med |
2,309 |
2,124 |
$181K |
| A4406 |
Pectin based ostomy paste |
4,313 |
4,270 |
$99K |
| A5120 |
Skin barrier, wipe or swab |
2,546 |
2,488 |
$93K |
| T4534 |
Youth size pull-on |
403 |
368 |
$62K |
| T4537 |
Reusable underpad bed size |
4,473 |
3,947 |
$41K |
| T4539 |
Reuse diaper/brief any size |
788 |
781 |
$16K |
| T1999 |
Noc retail items andsupplies |
403 |
377 |
$19.92 |
| W5511 |
|
812 |
794 |
$0.00 |
| A4335 |
Incontinence supply |
42 |
42 |
$0.00 |