| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult size pull-on med |
16,590 |
16,109 |
$1.93M |
| A6250 |
Skin seal protect moisturizr |
29,421 |
26,418 |
$1.82M |
| T4527 |
Adult size pull-on lg |
13,030 |
12,703 |
$1.74M |
| A4554 |
Disposable underpads |
30,009 |
29,364 |
$1.68M |
| A4927 |
Non-sterile gloves |
65,245 |
59,337 |
$1.59M |
| T4523 |
Adult size brief/diaper lg |
10,012 |
9,724 |
$1.29M |
| T4522 |
Adult size brief/diaper med |
8,990 |
8,736 |
$1.03M |
| T4528 |
Adult size pull-on xl |
8,238 |
7,981 |
$1.02M |
| T4534 |
Youth size pull-on |
4,992 |
4,790 |
$793K |
| T4535 |
Disposable liner/shield/pad |
15,948 |
15,490 |
$764K |
| B4150 |
Ef complet w/intact nutrient |
8,634 |
7,653 |
$722K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,265 |
2,827 |
$402K |
| T4524 |
Adult size brief/diaper xl |
2,942 |
2,856 |
$349K |
| A4553 |
Nondisp underpads, all sizes |
4,426 |
3,937 |
$245K |
| B4100 |
Food thickener oral |
3,327 |
2,475 |
$212K |
| T4525 |
Adult size pull-on sm |
1,275 |
1,235 |
$107K |
| B4154 |
Ef spec metabolic noninherit |
496 |
417 |
$97K |
| A6530 |
Compression stocking bk18-30 |
1,312 |
1,280 |
$64K |
| T4530 |
Ped size brief/diaper lg |
484 |
469 |
$46K |
| T4543 |
Adult disp brief/diap abv xl |
204 |
196 |
$38K |
| A9286 |
Any hygienic item, device |
1,555 |
1,535 |
$28K |
| T4521 |
Adult size brief/diaper sm |
85 |
81 |
$12K |
| A4357 |
Bedside drainage bag |
2,588 |
1,722 |
$7K |
| B4036 |
Enteral feed sup kit grav by |
64 |
48 |
$6K |
| A9901 |
Delivery/set up/dispensing |
317 |
263 |
$5K |
| T4537 |
Reusable underpad bed size |
125 |
97 |
$5K |
| B4035 |
Enteral feed supp pump per d |
16 |
12 |
$3K |
| A4351 |
Straight tip urine catheter |
26 |
24 |
$2K |
| T4533 |
Youth size brief/diaper |
13 |
13 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
19 |
12 |
$55.19 |