| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
6,768 |
6,185 |
$1.25M |
| T4522 |
Adult size brief/diaper med |
4,169 |
3,877 |
$768K |
| T4527 |
Adult size pull-on lg |
4,010 |
3,792 |
$745K |
| A4927 |
Non-sterile gloves |
16,872 |
15,492 |
$690K |
| B4150 |
Ef complet w/intact nutrient |
4,557 |
4,230 |
$643K |
| A4335 |
Incontinence supply |
21,524 |
19,850 |
$618K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,199 |
2,927 |
$612K |
| T4528 |
Adult size pull-on xl |
3,031 |
2,865 |
$606K |
| B4100 |
Food thickener oral |
3,145 |
2,645 |
$593K |
| T4526 |
Adult size pull-on med |
3,147 |
2,952 |
$566K |
| T4524 |
Adult size brief/diaper xl |
2,478 |
2,279 |
$490K |
| T4535 |
Disposable liner/shield/pad |
4,403 |
4,172 |
$454K |
| T4541 |
Large disposable underpad |
6,715 |
6,530 |
$361K |
| B4155 |
Ef incomplete/modular |
2,393 |
2,235 |
$216K |
| T4537 |
Reusable underpad bed size |
6,590 |
6,441 |
$196K |
| T4540 |
Reusable underpad chair size |
5,338 |
5,215 |
$138K |
| T4542 |
Small disposable underpad |
1,087 |
1,035 |
$69K |
| B4035 |
Enteral feed supp pump per d |
80 |
74 |
$21K |
| B4034 |
Enter feed supkit syr by day |
125 |
117 |
$15K |
| B4154 |
Ef spec metabolic noninherit |
71 |
66 |
$15K |
| A6402 |
Sterile gauze <= 16 sq in |
310 |
309 |
$5K |
| B4088 |
Gastro/jejuno tube, low-pro |
12 |
12 |
$2K |