| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
504,914 |
494,374 |
$11.26M |
| T4527 |
Adult size pull-on lg |
262,399 |
257,293 |
$10.83M |
| T4541 |
Large disposable underpad |
801,764 |
785,088 |
$10.07M |
| T4528 |
Adult size pull-on xl |
184,615 |
180,619 |
$9.97M |
| T4526 |
Adult size pull-on med |
243,128 |
238,386 |
$8.86M |
| T4523 |
Adult size brief/diaper lg |
99,533 |
97,542 |
$6.07M |
| T4544 |
Adlt disp und/pull on abv xl |
77,776 |
75,870 |
$5.42M |
| T4543 |
Adult disp brief/diap abv xl |
38,851 |
38,088 |
$5.09M |
| T4524 |
Adult size brief/diaper xl |
61,123 |
59,887 |
$4.40M |
| T4522 |
Adult size brief/diaper med |
87,070 |
85,349 |
$4.29M |
| S5199 |
Personal care item nos each |
797,155 |
785,076 |
$1.73M |
| T4521 |
Adult size brief/diaper sm |
24,897 |
24,331 |
$1.36M |
| T4525 |
Adult size pull-on sm |
32,541 |
31,866 |
$1.29M |
| T4533 |
Youth size brief/diaper |
20,740 |
20,341 |
$1.28M |
| A6250 |
Skin seal protect moisturizr |
506,131 |
495,518 |
$1.24M |
| A4649 |
Surgical supplies |
6,756 |
6,607 |
$922K |
| T4534 |
Youth size pull-on |
15,237 |
14,970 |
$736K |
| A4351 |
Straight tip urine catheter |
5,717 |
5,531 |
$344K |
| A4353 |
Intermittent urinary cath |
683 |
661 |
$309K |
| T4530 |
Ped size brief/diaper lg |
3,180 |
3,126 |
$175K |
| A4335 |
Incontinence supply |
5,088 |
4,979 |
$168K |
| A4520 |
Incontinence garment anytype |
11,993 |
11,724 |
$98K |
| A4352 |
Coude tip urinary catheter |
232 |
226 |
$39K |
| T4542 |
Small disposable underpad |
3,605 |
3,539 |
$26K |
| A4349 |
Disposable male external cat |
903 |
869 |
$24K |
| A4310 |
Insert tray w/o bag/cath |
2,652 |
2,589 |
$21K |
| A4357 |
Bedside drainage bag |
4,214 |
4,034 |
$16K |
| A4358 |
Urinary leg or abdomen bag |
2,222 |
2,128 |
$14K |
| A4344 |
Cath indw foley 2 way silicn |
394 |
375 |
$13K |
| A4331 |
Extension drainage tubing |
2,263 |
2,158 |
$9K |
| A4402 |
Lubricant per ounce |
5,660 |
5,572 |
$8K |
| T4532 |
Ped size pull-on lg |
106 |
103 |
$6K |
| A4322 |
Irrigation syringe |
842 |
823 |
$5K |
| A4338 |
Indwelling catheter latex |
1,849 |
1,821 |
$4K |
| A5120 |
Skin barrier, wipe or swab |
669 |
665 |
$3K |
| T4536 |
Reusable pull-on any size |
236 |
231 |
$2K |
| A4333 |
Urinary cath anchor device |
662 |
647 |
$2K |
| A4334 |
Urinary cath leg strap |
649 |
636 |
$1K |
| A4927 |
Non-sterile gloves |
20,543 |
20,520 |
$734.15 |
| A4320 |
Irrigation tray |
13 |
13 |
$70.52 |