| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
36,596 |
34,685 |
$3.66M |
| A4554 |
Disposable underpads |
73,254 |
68,525 |
$2.49M |
| T4526 |
Adult size pull-on med |
27,449 |
25,721 |
$2.44M |
| T4528 |
Adult size pull-on xl |
20,083 |
18,989 |
$2.07M |
| T4544 |
Adlt disp und/pull on abv xl |
11,331 |
10,568 |
$1.71M |
| A4353 |
Intermittent urinary cath |
1,550 |
1,325 |
$1.29M |
| T4525 |
Adult size pull-on sm |
6,514 |
6,009 |
$530K |
| A4927 |
Non-sterile gloves |
38,849 |
36,101 |
$512K |
| T4534 |
Youth size pull-on |
4,367 |
4,041 |
$497K |
| T4543 |
Adult disp brief/diap abv xl |
1,456 |
1,369 |
$241K |
| T4522 |
Adult size brief/diaper med |
1,824 |
1,719 |
$190K |
| A4351 |
Straight tip urine catheter |
1,773 |
1,217 |
$167K |
| T4530 |
Ped size brief/diaper lg |
1,769 |
1,673 |
$141K |
| T4523 |
Adult size brief/diaper lg |
1,230 |
1,121 |
$123K |
| T4524 |
Adult size brief/diaper xl |
626 |
570 |
$56K |
| A4357 |
Bedside drainage bag |
444 |
338 |
$6K |
| T4535 |
Disposable liner/shield/pad |
142 |
139 |
$4K |
| A6212 |
Foam drg <=16 sq in w/border |
49 |
28 |
$3K |
| T5999 |
Supply, nos |
249 |
248 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
81 |
66 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
30 |
24 |
$247.01 |
| A5120 |
Skin barrier, wipe or swab |
51 |
41 |
$165.72 |
| A4371 |
Skin barrier powder per oz |
15 |
12 |
$23.55 |
| A4520 |
Incontinence garment anytype |
59 |
59 |
$0.00 |