| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
391,324 |
384,782 |
$35.55M |
| T4535 |
Disposable liner/shield/pad |
786,999 |
772,481 |
$34.05M |
| T4528 |
Adult size pull-on xl |
266,958 |
262,478 |
$28.37M |
| T4526 |
Adult size pull-on med |
285,845 |
280,350 |
$23.06M |
| T4541 |
Large disposable underpad |
620,781 |
608,480 |
$22.29M |
| T4544 |
Adlt disp und/pull on abv xl |
76,388 |
74,673 |
$12.87M |
| T4534 |
Youth size pull-on |
76,051 |
72,976 |
$6.91M |
| A4927 |
Non-sterile gloves |
531,808 |
496,630 |
$6.56M |
| T4522 |
Adult size brief/diaper med |
58,085 |
55,294 |
$5.82M |
| T4525 |
Adult size pull-on sm |
68,922 |
67,134 |
$5.15M |
| T4530 |
Ped size brief/diaper lg |
39,589 |
38,481 |
$5.06M |
| T4523 |
Adult size brief/diaper lg |
45,344 |
43,651 |
$4.92M |
| T4537 |
Reusable underpad bed size |
112,398 |
110,757 |
$4.21M |
| T4543 |
Adult disp brief/diap abv xl |
16,405 |
15,792 |
$3.24M |
| T4524 |
Adult size brief/diaper xl |
26,262 |
25,517 |
$3.13M |
| A4554 |
Disposable underpads |
116,425 |
108,362 |
$2.29M |
| B4150 |
Ef complet w/intact nutrient |
27,431 |
26,032 |
$2.24M |
| A4520 |
Incontinence garment anytype |
43,372 |
37,252 |
$1.97M |
| S5170 |
Homedelivered prepared meal |
37,690 |
25,244 |
$1.81M |
| T4521 |
Adult size brief/diaper sm |
16,513 |
16,008 |
$1.70M |
| T4540 |
Reusable underpad chair size |
64,434 |
63,618 |
$1.35M |
| A4351 |
Straight tip urine catheter |
12,774 |
9,652 |
$1.16M |
| E1399 |
Durable medical equipment mi |
9,578 |
8,826 |
$907K |
| T2029 |
Special med equip, noswaiver |
31,579 |
28,555 |
$750K |
| T4529 |
Ped size brief/diaper sm/med |
5,995 |
5,779 |
$722K |
| B4154 |
Ef spec metabolic noninherit |
6,860 |
6,684 |
$677K |
| A4353 |
Intermittent urinary cath |
1,310 |
1,045 |
$629K |
| T4532 |
Ped size pull-on lg |
5,783 |
5,598 |
$499K |
| A9999 |
Dme supply or accessory, nos |
9,714 |
9,386 |
$413K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,903 |
2,119 |
$358K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,073 |
1,889 |
$242K |
| A4335 |
Incontinence supply |
12,488 |
11,674 |
$196K |
| T4531 |
Ped size pull-on sm/med |
890 |
854 |
$75K |
| A4385 |
Ost skn barrier sld ext wear |
1,611 |
1,341 |
$61K |
| A4349 |
Disposable male external cat |
3,022 |
2,444 |
$60K |
| A4357 |
Bedside drainage bag |
7,722 |
5,796 |
$49K |
| A4409 |
Ost skn barr convex <=4 sq i |
1,153 |
899 |
$32K |
| A4358 |
Urinary leg or abdomen bag |
6,082 |
4,530 |
$29K |
| B4100 |
Food thickener oral |
547 |
500 |
$24K |
| A5063 |
Drain ostomy pouch w/flange |
1,321 |
1,037 |
$18K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
614 |
502 |
$17K |
| A4402 |
Lubricant per ounce |
4,822 |
4,190 |
$16K |
| A4452 |
Waterproof tape |
1,433 |
1,136 |
$15K |
| A4352 |
Coude tip urinary catheter |
54 |
50 |
$14K |
| T4542 |
Small disposable underpad |
863 |
847 |
$14K |
| A6402 |
Sterile gauze <= 16 sq in |
1,359 |
1,085 |
$11K |
| A4314 |
Cath w/drainage 2-way latex |
2,120 |
1,480 |
$10K |
| A5120 |
Skin barrier, wipe or swab |
2,128 |
1,750 |
$9K |
| A4407 |
Ext wear ost skn barr <=4sq" |
170 |
121 |
$8K |
| A4425 |
Ost pch drain for barrier fl |
355 |
241 |
$7K |
| A4322 |
Irrigation syringe |
779 |
662 |
$6K |
| A4406 |
Pectin based ostomy paste |
814 |
699 |
$5K |
| A4338 |
Indwelling catheter latex |
787 |
666 |
$5K |
| A4456 |
Adhesive remover, wipes |
963 |
789 |
$4K |
| T1999 |
Noc retail items andsupplies |
1,443 |
1,046 |
$4K |
| T2028 |
Special supply, nos waiver |
116 |
103 |
$4K |
| A5061 |
Pouch drainable w barrier at |
85 |
73 |
$4K |
| A4332 |
Lube sterile packet |
1,281 |
670 |
$3K |
| A4553 |
Nondisp underpads, all sizes |
4,740 |
2,453 |
$3K |
| A4310 |
Insert tray w/o bag/cath |
317 |
281 |
$3K |
| A4334 |
Urinary cath leg strap |
980 |
745 |
$1K |
| A4450 |
Non-waterproof tape |
331 |
292 |
$905.55 |
| A4670 |
Automatic bp monitor, dial |
15 |
13 |
$823.89 |
| A4371 |
Skin barrier powder per oz |
219 |
194 |
$555.76 |
| A4388 |
Drainable pch w ex wear barr |
13 |
12 |
$299.60 |
| A4245 |
Alcohol wipes per box |
58 |
49 |
$200.61 |
| A4367 |
Ostomy belt |
31 |
24 |
$80.67 |
| A4394 |
Ostomy pouch liq deodorant |
16 |
12 |
$80.47 |
| A4217 |
Sterile water/saline, 500 ml |
18 |
12 |
$56.44 |