| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
31,797 |
31,269 |
$2.70M |
| T4522 |
Adult size brief/diaper med |
35,857 |
35,401 |
$2.47M |
| A4554 |
Disposable underpads |
72,995 |
71,795 |
$2.47M |
| T4535 |
Disposable liner/shield/pad |
71,719 |
70,458 |
$2.33M |
| T4524 |
Adult size brief/diaper xl |
19,142 |
18,858 |
$1.72M |
| T4533 |
Youth size brief/diaper |
24,005 |
23,874 |
$1.60M |
| T4537 |
Reusable underpad bed size |
55,473 |
54,785 |
$1.60M |
| T4521 |
Adult size brief/diaper sm |
15,332 |
15,190 |
$1.17M |
| T4530 |
Ped size brief/diaper lg |
13,870 |
13,768 |
$993K |
| T4543 |
Adult disp brief/diap abv xl |
5,688 |
5,581 |
$863K |
| T4540 |
Reusable underpad chair size |
30,987 |
30,537 |
$509K |
| T4528 |
Adult size pull-on xl |
5,506 |
5,465 |
$499K |
| T4527 |
Adult size pull-on lg |
6,065 |
6,044 |
$419K |
| T4534 |
Youth size pull-on |
3,584 |
3,529 |
$369K |
| T4526 |
Adult size pull-on med |
5,570 |
5,520 |
$331K |
| A4927 |
Non-sterile gloves |
55,037 |
53,301 |
$237K |
| T4541 |
Large disposable underpad |
10,166 |
10,043 |
$155K |
| T4529 |
Ped size brief/diaper sm/med |
2,608 |
2,589 |
$153K |
| A4351 |
Straight tip urine catheter |
1,078 |
1,015 |
$126K |
| T4525 |
Adult size pull-on sm |
1,543 |
1,536 |
$101K |
| A6212 |
Foam drg <=16 sq in w/border |
320 |
301 |
$24K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
394 |
374 |
$24K |
| A6402 |
Sterile gauze <= 16 sq in |
1,245 |
1,207 |
$23K |
| T4532 |
Ped size pull-on lg |
260 |
257 |
$20K |
| A6197 |
Alginate drsg >16 <=48 sq in |
179 |
174 |
$18K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
179 |
177 |
$18K |
| A4385 |
Ost skn barrier sld ext wear |
190 |
183 |
$11K |
| A4452 |
Waterproof tape |
473 |
468 |
$9K |
| A4409 |
Ost skn barr convex <=4 sq i |
157 |
143 |
$9K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
182 |
179 |
$8K |
| A6446 |
Conform band s w>=3" <5"/yd |
613 |
598 |
$6K |
| A4216 |
Sterile water/saline, 10 ml |
192 |
182 |
$5K |
| A4357 |
Bedside drainage bag |
378 |
325 |
$5K |
| A4353 |
Intermittent urinary cath |
13 |
12 |
$4K |
| E0603 |
Electric breast pump |
17 |
17 |
$3K |
| A5120 |
Skin barrier, wipe or swab |
339 |
323 |
$2K |
| A4425 |
Ost pch drain for barrier fl |
41 |
40 |
$2K |
| A4349 |
Disposable male external cat |
118 |
92 |
$2K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
13 |
13 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
435 |
428 |
$2K |
| A4450 |
Non-waterproof tape |
300 |
292 |
$2K |
| A4358 |
Urinary leg or abdomen bag |
214 |
173 |
$1K |
| A5063 |
Drain ostomy pouch w/flange |
30 |
27 |
$1K |
| A4456 |
Adhesive remover, wipes |
115 |
115 |
$1K |
| A4419 |
Ost pch for bar w flange/flt |
12 |
12 |
$1K |
| A4520 |
Incontinence garment anytype |
2,246 |
2,221 |
$1K |
| A4362 |
Solid skin barrier |
13 |
13 |
$917.50 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
12 |
12 |
$895.05 |
| A6454 |
Self-adher band w>=3" <5"/yd |
60 |
59 |
$820.12 |
| A4402 |
Lubricant per ounce |
206 |
194 |
$445.96 |
| A6450 |
Lt compres band >=5"/yd |
42 |
42 |
$394.40 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
12 |
12 |
$372.65 |
| A6449 |
Lt compres band >=3" <5"/yd |
73 |
72 |
$343.00 |
| A6258 |
Transparent film >16<=48 in |
12 |
12 |
$279.63 |
| A6403 |
Sterile gauze>16 <= 48 sq in |
12 |
12 |
$264.60 |
| A4371 |
Skin barrier powder per oz |
30 |
28 |
$125.69 |
| A4553 |
Nondisp underpads, all sizes |
44 |
43 |
$43.68 |