| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
13,363 |
12,331 |
$932K |
| T4535 |
Disposable liner/shield/pad |
9,912 |
9,240 |
$728K |
| T4527 |
Adult size pull-on lg |
2,449 |
2,259 |
$333K |
| A4927 |
Non-sterile gloves |
13,996 |
12,622 |
$247K |
| T4523 |
Adult size brief/diaper lg |
1,880 |
1,711 |
$237K |
| T4534 |
Youth size pull-on |
1,194 |
1,103 |
$187K |
| T4524 |
Adult size brief/diaper xl |
1,529 |
1,337 |
$179K |
| T4528 |
Adult size pull-on xl |
1,328 |
1,223 |
$179K |
| T4522 |
Adult size brief/diaper med |
1,299 |
1,235 |
$137K |
| T4526 |
Adult size pull-on med |
810 |
751 |
$111K |
| A9286 |
Any hygienic item, device |
1,356 |
1,200 |
$81K |
| A6212 |
Foam drg <=16 sq in w/border |
782 |
512 |
$67K |
| T4530 |
Ped size brief/diaper lg |
463 |
419 |
$61K |
| T4544 |
Adlt disp und/pull on abv xl |
198 |
180 |
$46K |
| T4543 |
Adult disp brief/diap abv xl |
53 |
49 |
$12K |
| A5120 |
Skin barrier, wipe or swab |
1,701 |
1,398 |
$12K |
| A4217 |
Sterile water/saline, 500 ml |
1,715 |
1,265 |
$9K |
| A6216 |
Non-sterile gauze<=16 sq in |
1,413 |
1,144 |
$8K |
| T4537 |
Reusable underpad bed size |
1,731 |
1,648 |
$7K |
| A4450 |
Non-waterproof tape |
1,297 |
926 |
$6K |
| A6402 |
Sterile gauze <= 16 sq in |
596 |
481 |
$5K |
| A4357 |
Bedside drainage bag |
605 |
442 |
$4K |
| A4351 |
Straight tip urine catheter |
69 |
61 |
$4K |
| A4377 |
Drainable plstic pch w/o fp |
88 |
74 |
$4K |
| A4384 |
Ostomy faceplt/silicone ring |
14 |
12 |
$1K |
| A4456 |
Adhesive remover, wipes |
179 |
157 |
$1K |
| A6240 |
Hydrocolld drg filler paste |
45 |
38 |
$1K |
| A4310 |
Insert tray w/o bag/cath |
260 |
187 |
$943.57 |
| A6446 |
Conform band s w>=3" <5"/yd |
33 |
24 |
$927.50 |
| A4402 |
Lubricant per ounce |
196 |
175 |
$452.96 |
| A4338 |
Indwelling catheter latex |
34 |
24 |
$134.85 |
| A5131 |
Appliance cleaner |
27 |
24 |
$128.27 |