| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
101,301 |
97,604 |
$5.67M |
| T4526 |
Adult size pull-on med |
96,355 |
92,625 |
$5.09M |
| A4554 |
Disposable underpads |
139,339 |
132,556 |
$3.57M |
| T4528 |
Adult size pull-on xl |
46,287 |
44,128 |
$2.85M |
| T4535 |
Disposable liner/shield/pad |
49,311 |
47,412 |
$2.16M |
| T4525 |
Adult size pull-on sm |
20,925 |
20,130 |
$1.14M |
| A4927 |
Non-sterile gloves |
147,785 |
140,990 |
$1.08M |
| T4524 |
Adult size brief/diaper xl |
15,902 |
15,044 |
$1.05M |
| T4523 |
Adult size brief/diaper lg |
16,486 |
15,734 |
$957K |
| A4245 |
Alcohol wipes per box |
131,209 |
125,747 |
$749K |
| S5199 |
Personal care item nos each |
28,599 |
26,447 |
$613K |
| T4522 |
Adult size brief/diaper med |
9,955 |
9,548 |
$518K |
| T4543 |
Adult disp brief/diap abv xl |
4,108 |
3,884 |
$455K |
| B4150 |
Ef complet w/intact nutrient |
5,919 |
4,415 |
$454K |
| A4335 |
Incontinence supply |
57,054 |
51,525 |
$450K |
| T4544 |
Adlt disp und/pull on abv xl |
5,252 |
4,987 |
$428K |
| T4541 |
Large disposable underpad |
12,118 |
11,786 |
$408K |
| A5120 |
Skin barrier, wipe or swab |
38,457 |
36,149 |
$389K |
| A6250 |
Skin seal protect moisturizr |
34,622 |
32,880 |
$194K |
| B4154 |
Ef spec metabolic noninherit |
1,587 |
1,196 |
$144K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,606 |
1,187 |
$126K |
| T4542 |
Small disposable underpad |
1,538 |
1,504 |
$95K |
| T4537 |
Reusable underpad bed size |
2,244 |
2,177 |
$76K |
| A9900 |
Supply/accessory/service |
1,012 |
435 |
$52K |
| T4521 |
Adult size brief/diaper sm |
687 |
674 |
$35K |
| T5999 |
Supply, nos |
293 |
238 |
$2K |
| T4540 |
Reusable underpad chair size |
94 |
88 |
$2K |
| A9270 |
Non-covered item or service |
45 |
43 |
$288.00 |