| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads |
48,114 |
46,026 |
$2.18M |
| T4527 |
Adult size pull-on lg |
17,507 |
16,682 |
$1.89M |
| T4526 |
Adult size pull-on med |
17,544 |
16,704 |
$1.68M |
| A4927 |
Non-sterile gloves |
35,008 |
33,509 |
$1.32M |
| T4528 |
Adult size pull-on xl |
10,297 |
9,811 |
$1.08M |
| T4534 |
Youth size pull-on |
8,651 |
8,044 |
$970K |
| B4150 |
Ef complet w/intact nutrient |
9,375 |
7,888 |
$896K |
| T4544 |
Adlt disp und/pull on abv xl |
4,833 |
4,614 |
$786K |
| T4522 |
Adult size brief/diaper med |
5,045 |
4,830 |
$557K |
| B4154 |
Ef spec metabolic noninherit |
3,723 |
3,194 |
$468K |
| T4523 |
Adult size brief/diaper lg |
4,012 |
3,788 |
$436K |
| T4532 |
Ped size pull-on lg |
2,945 |
2,762 |
$356K |
| T4530 |
Ped size brief/diaper lg |
3,798 |
3,475 |
$319K |
| T4543 |
Adult disp brief/diap abv xl |
1,757 |
1,671 |
$270K |
| A4351 |
Straight tip urine catheter |
1,897 |
1,366 |
$269K |
| T4524 |
Adult size brief/diaper xl |
1,968 |
1,844 |
$222K |
| T4535 |
Disposable liner/shield/pad |
5,885 |
5,240 |
$205K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,678 |
1,493 |
$148K |
| T4521 |
Adult size brief/diaper sm |
729 |
690 |
$78K |
| B4152 |
Ef calorie dense>/=1.5kcal |
490 |
404 |
$68K |
| A4357 |
Bedside drainage bag |
1,272 |
919 |
$10K |
| A4349 |
Disposable male external cat |
141 |
87 |
$3K |
| A4402 |
Lubricant per ounce |
915 |
703 |
$3K |
| E0570 |
Nebulizer with compression |
19 |
14 |
$2K |
| A4331 |
Extension drainage tubing |
24 |
24 |
$85.61 |
| A4253 |
Blood glucose/reagent strips |
41 |
40 |
$63.23 |