| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
63,682 |
62,087 |
$3.87M |
| A4554 |
Disposable underpads |
136,790 |
131,291 |
$3.31M |
| T4526 |
Adult size pull-on med |
59,996 |
58,610 |
$3.31M |
| T4528 |
Adult size pull-on xl |
33,305 |
32,517 |
$2.34M |
| A4245 |
Alcohol wipes per box |
139,134 |
133,985 |
$1.32M |
| T4544 |
Adlt disp und/pull on abv xl |
12,364 |
12,088 |
$1.27M |
| A4927 |
Non-sterile gloves |
156,049 |
150,198 |
$1.19M |
| T4543 |
Adult disp brief/diap abv xl |
10,044 |
9,810 |
$1.14M |
| T4535 |
Disposable liner/shield/pad |
24,862 |
24,243 |
$1.08M |
| T4523 |
Adult size brief/diaper lg |
14,514 |
14,133 |
$833K |
| T4524 |
Adult size brief/diaper xl |
11,506 |
11,225 |
$824K |
| T4522 |
Adult size brief/diaper med |
8,838 |
8,591 |
$489K |
| T4525 |
Adult size pull-on sm |
8,689 |
8,509 |
$478K |
| S5199 |
Personal care item nos each |
29,303 |
27,576 |
$416K |
| B4150 |
Ef complet w/intact nutrient |
2,864 |
2,714 |
$365K |
| A5120 |
Skin barrier, wipe or swab |
49,734 |
47,433 |
$303K |
| A4353 |
Intermittent urinary cath |
460 |
429 |
$250K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,930 |
1,560 |
$240K |
| A4335 |
Incontinence supply |
6,727 |
5,757 |
$213K |
| E1399 |
Durable medical equipment mi |
1,090 |
961 |
$140K |
| B4154 |
Ef spec metabolic noninherit |
1,053 |
871 |
$139K |
| B4035 |
Enteral feed supp pump per d |
576 |
546 |
$117K |
| B4149 |
Ef blenderized foods |
134 |
122 |
$66K |
| A4349 |
Disposable male external cat |
1,148 |
919 |
$41K |
| A6197 |
Alginate drsg >16 <=48 sq in |
54 |
50 |
$33K |
| A4216 |
Sterile water/saline, 10 ml |
674 |
637 |
$31K |
| A4357 |
Bedside drainage bag |
2,445 |
1,989 |
$28K |
| T4521 |
Adult size brief/diaper sm |
453 |
449 |
$25K |
| A6402 |
Sterile gauze <= 16 sq in |
1,626 |
1,427 |
$22K |
| A4312 |
Cath w/o bag 2-way silicone |
612 |
584 |
$19K |
| T4537 |
Reusable underpad bed size |
1,898 |
1,859 |
$19K |
| A4452 |
Waterproof tape |
369 |
348 |
$18K |
| A4358 |
Urinary leg or abdomen bag |
1,308 |
1,014 |
$12K |
| A6216 |
Non-sterile gauze<=16 sq in |
759 |
665 |
$9K |
| B9002 |
Enter nutr inf pump any type |
158 |
141 |
$8K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
12 |
12 |
$8K |
| A4450 |
Non-waterproof tape |
265 |
222 |
$8K |
| A6212 |
Foam drg <=16 sq in w/border |
24 |
24 |
$6K |
| A6250 |
Skin seal protect moisturizr |
141 |
135 |
$2K |
| E0603 |
Electric breast pump |
18 |
18 |
$2K |
| A4456 |
Adhesive remover, wipes |
239 |
199 |
$2K |
| A6446 |
Conform band s w>=3" <5"/yd |
16 |
13 |
$1K |
| B4034 |
Enter feed supkit syr by day |
12 |
12 |
$1K |
| B9998 |
Enteral supp not otherwise c |
53 |
36 |
$901.50 |