| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
15,700 |
15,077 |
$944K |
| A4554 |
Disposable underpads |
32,108 |
30,981 |
$883K |
| T4526 |
Adult size pull-on med |
13,791 |
13,256 |
$779K |
| T4528 |
Adult size pull-on xl |
8,534 |
8,158 |
$641K |
| A4245 |
Alcohol wipes per box |
38,121 |
37,026 |
$484K |
| T4535 |
Disposable liner/shield/pad |
12,852 |
12,433 |
$392K |
| A6250 |
Skin seal protect moisturizr |
23,691 |
22,734 |
$300K |
| T4524 |
Adult size brief/diaper xl |
2,199 |
2,116 |
$196K |
| E0570 |
Nebulizer with compression |
2,408 |
2,288 |
$159K |
| T4523 |
Adult size brief/diaper lg |
2,109 |
2,043 |
$151K |
| T4525 |
Adult size pull-on sm |
2,461 |
2,318 |
$129K |
| T4522 |
Adult size brief/diaper med |
785 |
756 |
$56K |
| A5120 |
Skin barrier, wipe or swab |
6,167 |
6,024 |
$51K |
| A4927 |
Non-sterile gloves |
8,040 |
7,768 |
$38K |
| B4150 |
Ef complet w/intact nutrient |
274 |
273 |
$31K |
| A7003 |
Nebulizer administration set |
1,915 |
1,856 |
$23K |
| B4154 |
Ef spec metabolic noninherit |
106 |
92 |
$15K |
| A7005 |
Nondisposable nebulizer set |
127 |
127 |
$5K |
| T4542 |
Small disposable underpad |
137 |
137 |
$4K |
| S5199 |
Personal care item nos each |
96 |
82 |
$3K |
| A4335 |
Incontinence supply |
402 |
369 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
2,135 |
2,095 |
$2K |
| B4152 |
Ef calorie dense>/=1.5kcal |
15 |
12 |
$957.10 |
| T4541 |
Large disposable underpad |
37 |
37 |
$908.92 |