| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
26,181 |
26,087 |
$1.47M |
| T4535 |
Disposable liner/shield/pad |
13,956 |
13,635 |
$735K |
| T4523 |
Adult size brief/diaper lg |
6,729 |
6,663 |
$665K |
| T4527 |
Adult size pull-on lg |
6,223 |
6,177 |
$434K |
| T4522 |
Adult size brief/diaper med |
4,581 |
4,563 |
$408K |
| T4526 |
Adult size pull-on med |
4,839 |
4,819 |
$286K |
| T4528 |
Adult size pull-on xl |
3,495 |
3,465 |
$247K |
| B4154 |
Ef spec metabolic noninherit |
1,372 |
1,345 |
$243K |
| T4524 |
Adult size brief/diaper xl |
2,794 |
2,781 |
$240K |
| T4534 |
Youth size pull-on |
746 |
744 |
$136K |
| A6250 |
Skin seal protect moisturizr |
9,151 |
9,115 |
$132K |
| T4537 |
Reusable underpad bed size |
3,529 |
3,513 |
$124K |
| A4335 |
Incontinence supply |
8,821 |
8,745 |
$97K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
304 |
296 |
$50K |
| T4536 |
Reusable pull-on any size |
3,040 |
2,976 |
$27K |
| B4161 |
Ef ped hydrolyzed/amino acid |
39 |
39 |
$14K |
| A4927 |
Non-sterile gloves |
617 |
615 |
$10K |
| T4521 |
Adult size brief/diaper sm |
80 |
75 |
$7K |