| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5199 |
Personal care item nos each |
106,380 |
84,458 |
$7.52M |
| A4353 |
Intermittent urinary cath |
9,028 |
8,060 |
$4.26M |
| A4554 |
Disposable underpads |
53,078 |
48,968 |
$2.83M |
| B4150 |
Ef complet w/intact nutrient |
15,783 |
11,484 |
$2.17M |
| T4526 |
Adult size pull-on med |
25,395 |
22,969 |
$2.05M |
| T4527 |
Adult size pull-on lg |
23,596 |
21,345 |
$2.02M |
| T4528 |
Adult size pull-on xl |
17,859 |
16,072 |
$1.73M |
| T4522 |
Adult size brief/diaper med |
16,469 |
15,024 |
$1.26M |
| A9900 |
Supply/accessory/service |
22,092 |
17,838 |
$1.18M |
| B4152 |
Ef calorie dense>/=1.5kcal |
7,770 |
5,417 |
$1.12M |
| A4927 |
Non-sterile gloves |
68,277 |
58,673 |
$1.10M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
9,945 |
7,913 |
$1.09M |
| T4523 |
Adult size brief/diaper lg |
11,760 |
10,703 |
$1.06M |
| T4524 |
Adult size brief/diaper xl |
5,262 |
4,773 |
$515K |
| T4535 |
Disposable liner/shield/pad |
14,111 |
12,665 |
$505K |
| T4534 |
Youth size pull-on |
9,011 |
8,485 |
$504K |
| T4525 |
Adult size pull-on sm |
5,558 |
4,961 |
$418K |
| A4351 |
Straight tip urine catheter |
4,519 |
3,723 |
$350K |
| T4521 |
Adult size brief/diaper sm |
5,209 |
4,662 |
$305K |
| A4335 |
Incontinence supply |
3,883 |
3,525 |
$249K |
| B4154 |
Ef spec metabolic noninherit |
1,133 |
790 |
$230K |
| T4532 |
Ped size pull-on lg |
4,034 |
3,563 |
$211K |
| T4530 |
Ped size brief/diaper lg |
4,112 |
3,861 |
$158K |
| T4544 |
Adlt disp und/pull on abv xl |
1,176 |
1,021 |
$155K |
| A4213 |
20+ cc syringe only |
1,122 |
987 |
$83K |
| A4332 |
Lube sterile packet |
1,520 |
1,314 |
$82K |
| T4533 |
Youth size brief/diaper |
1,367 |
1,289 |
$66K |
| T4543 |
Adult disp brief/diap abv xl |
266 |
259 |
$51K |
| A4409 |
Ost skn barr convex <=4 sq i |
707 |
625 |
$34K |
| A4352 |
Coude tip urinary catheter |
234 |
176 |
$26K |
| A4385 |
Ost skn barrier sld ext wear |
859 |
758 |
$22K |
| A4371 |
Skin barrier powder per oz |
1,052 |
993 |
$18K |
| A4357 |
Bedside drainage bag |
1,628 |
1,509 |
$18K |
| A4425 |
Ost pch drain for barrier fl |
871 |
803 |
$16K |
| A4245 |
Alcohol wipes per box |
546 |
511 |
$13K |
| A4520 |
Incontinence garment anytype |
465 |
351 |
$11K |
| A9999 |
Dme supply or accessory, nos |
567 |
448 |
$10K |
| A4362 |
Solid skin barrier |
208 |
195 |
$10K |
| A4349 |
Disposable male external cat |
358 |
307 |
$9K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
278 |
260 |
$9K |
| A5120 |
Skin barrier, wipe or swab |
2,374 |
2,160 |
$6K |
| A4456 |
Adhesive remover, wipes |
2,296 |
2,117 |
$5K |
| A4358 |
Urinary leg or abdomen bag |
797 |
747 |
$5K |
| A4322 |
Irrigation syringe |
48 |
43 |
$3K |
| A4394 |
Ostomy pouch liq deodorant |
369 |
329 |
$2K |
| T4541 |
Large disposable underpad |
41 |
39 |
$2K |
| T4531 |
Ped size pull-on sm/med |
68 |
64 |
$2K |
| A4406 |
Pectin based ostomy paste |
186 |
176 |
$1K |
| A5063 |
Drain ostomy pouch w/flange |
48 |
39 |
$441.95 |
| A6250 |
Skin seal protect moisturizr |
52 |
47 |
$242.96 |
| A4649 |
Surgical supplies |
13 |
12 |
$115.23 |
| A4310 |
Insert tray w/o bag/cath |
445 |
408 |
$24.18 |
| A9270 |
Non-covered item or service |
22 |
18 |
$0.00 |
| A5061 |
Pouch drainable w barrier at |
12 |
12 |
$0.00 |