| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
28,518 |
28,024 |
$1.29M |
| A4245 |
Alcohol wipes per box |
86,637 |
85,114 |
$1.08M |
| T4526 |
Adult size pull-on med |
23,561 |
23,202 |
$1.07M |
| A4554 |
Disposable underpads |
50,844 |
49,726 |
$923K |
| T4528 |
Adult size pull-on xl |
15,639 |
15,364 |
$891K |
| A4927 |
Non-sterile gloves |
64,203 |
62,939 |
$589K |
| A4335 |
Incontinence supply |
5,724 |
5,597 |
$508K |
| T4525 |
Adult size pull-on sm |
7,573 |
7,451 |
$391K |
| T4535 |
Disposable liner/shield/pad |
8,921 |
8,791 |
$384K |
| T4544 |
Adlt disp und/pull on abv xl |
4,166 |
4,081 |
$360K |
| T4523 |
Adult size brief/diaper lg |
5,454 |
5,334 |
$319K |
| T4524 |
Adult size brief/diaper xl |
5,173 |
5,089 |
$280K |
| T4543 |
Adult disp brief/diap abv xl |
2,695 |
2,617 |
$276K |
| B4150 |
Ef complet w/intact nutrient |
1,925 |
1,872 |
$193K |
| T4522 |
Adult size brief/diaper med |
3,191 |
3,138 |
$177K |
| B4152 |
Ef calorie dense>/=1.5kcal |
567 |
560 |
$67K |
| B4154 |
Ef spec metabolic noninherit |
257 |
253 |
$35K |
| A5120 |
Skin barrier, wipe or swab |
167 |
140 |
$12K |
| S5199 |
Personal care item nos each |
532 |
498 |
$9K |
| T4521 |
Adult size brief/diaper sm |
91 |
89 |
$6K |
| T4537 |
Reusable underpad bed size |
614 |
606 |
$1K |