| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
32,304 |
26,310 |
$1.36M |
| T4526 |
Adult size pull-on med |
15,196 |
12,683 |
$978K |
| T4527 |
Adult size pull-on lg |
12,816 |
10,610 |
$977K |
| T4528 |
Adult size pull-on xl |
10,020 |
8,268 |
$733K |
| A4554 |
Disposable underpads |
24,812 |
21,240 |
$669K |
| A4927 |
Non-sterile gloves |
28,323 |
20,372 |
$513K |
| A6250 |
Skin seal protect moisturizr |
23,955 |
16,044 |
$328K |
| T4544 |
Adlt disp und/pull on abv xl |
3,324 |
2,751 |
$319K |
| B4154 |
Ef spec metabolic noninherit |
1,731 |
1,167 |
$251K |
| B4150 |
Ef complet w/intact nutrient |
4,055 |
2,625 |
$240K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,193 |
816 |
$114K |
| T4525 |
Adult size pull-on sm |
2,088 |
1,692 |
$93K |
| T4523 |
Adult size brief/diaper lg |
1,035 |
811 |
$92K |
| T4522 |
Adult size brief/diaper med |
610 |
515 |
$49K |
| T4534 |
Youth size pull-on |
419 |
326 |
$32K |
| T4524 |
Adult size brief/diaper xl |
219 |
173 |
$14K |
| T4543 |
Adult disp brief/diap abv xl |
15 |
12 |
$2K |