| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult size pull-on med |
72,738 |
72,397 |
$5.46M |
| A4927 |
Non-sterile gloves |
184,784 |
183,938 |
$5.26M |
| T4534 |
Youth size pull-on |
37,482 |
37,334 |
$5.05M |
| T4527 |
Adult size pull-on lg |
60,715 |
60,419 |
$4.89M |
| T4523 |
Adult size brief/diaper lg |
42,367 |
42,189 |
$4.55M |
| B4150 |
Ef complet w/intact nutrient |
35,531 |
34,673 |
$4.42M |
| T4541 |
Large disposable underpad |
116,953 |
116,502 |
$3.68M |
| T4535 |
Disposable liner/shield/pad |
78,935 |
78,503 |
$3.60M |
| T4528 |
Adult size pull-on xl |
34,239 |
34,050 |
$3.42M |
| T4522 |
Adult size brief/diaper med |
39,184 |
38,912 |
$3.41M |
| B4161 |
Ef ped hydrolyzed/amino acid |
8,020 |
7,790 |
$3.34M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
25,098 |
24,339 |
$3.05M |
| T4530 |
Ped size brief/diaper lg |
21,672 |
21,530 |
$2.51M |
| T4524 |
Adult size brief/diaper xl |
17,399 |
17,302 |
$2.10M |
| B4152 |
Ef calorie dense>/=1.5kcal |
12,092 |
11,700 |
$1.65M |
| T4544 |
Adlt disp und/pull on abv xl |
10,908 |
10,733 |
$1.61M |
| T4543 |
Adult disp brief/diap abv xl |
6,733 |
6,653 |
$1.59M |
| T4525 |
Adult size pull-on sm |
15,105 |
15,010 |
$1.50M |
| T4537 |
Reusable underpad bed size |
92,315 |
92,094 |
$1.48M |
| T4532 |
Ped size pull-on lg |
10,772 |
10,704 |
$1.42M |
| S9342 |
Hit enteral pump diem |
2,519 |
2,501 |
$1.14M |
| B4154 |
Ef spec metabolic noninherit |
8,024 |
7,691 |
$965K |
| B4100 |
Food thickener oral |
13,872 |
13,789 |
$785K |
| A4351 |
Straight tip urine catheter |
3,846 |
3,504 |
$534K |
| B4088 |
Gastro/jejuno tube, low-pro |
3,938 |
3,686 |
$459K |
| T4521 |
Adult size brief/diaper sm |
4,436 |
4,369 |
$437K |
| A9901 |
Delivery/set up/dispensing |
106,455 |
104,192 |
$298K |
| S9343 |
Hit enteral bolus nurs |
723 |
721 |
$273K |
| T4533 |
Youth size brief/diaper |
2,380 |
2,342 |
$249K |
| B4102 |
Ef adult fluids and electro |
1,499 |
1,445 |
$151K |
| A4349 |
Disposable male external cat |
2,510 |
2,152 |
$140K |
| A4353 |
Intermittent urinary cath |
305 |
286 |
$112K |
| B4035 |
Enteral feed supp pump per d |
360 |
359 |
$55K |
| B4155 |
Ef incomplete/modular |
472 |
463 |
$32K |
| B4034 |
Enter feed supkit syr by day |
266 |
250 |
$25K |
| A4357 |
Bedside drainage bag |
3,273 |
3,128 |
$25K |
| A4332 |
Lube sterile packet |
1,479 |
1,395 |
$14K |
| T4531 |
Ped size pull-on sm/med |
91 |
91 |
$11K |
| A4358 |
Urinary leg or abdomen bag |
1,902 |
1,809 |
$10K |
| A4322 |
Irrigation syringe |
90 |
86 |
$5K |
| E1399 |
Durable medical equipment mi |
652 |
619 |
$4K |
| A4335 |
Incontinence supply |
468 |
417 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
219 |
215 |
$3K |