| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
16,465 |
16,165 |
$543K |
| T4535 |
Disposable liner/shield/pad |
12,458 |
11,517 |
$536K |
| T4527 |
Adult size pull-on lg |
4,697 |
4,584 |
$212K |
| T4526 |
Adult size pull-on med |
5,158 |
5,076 |
$182K |
| T4528 |
Adult size pull-on xl |
2,841 |
2,771 |
$127K |
| T4523 |
Adult size brief/diaper lg |
1,871 |
1,829 |
$119K |
| A6250 |
Skin seal protect moisturizr |
10,423 |
9,173 |
$107K |
| T4524 |
Adult size brief/diaper xl |
1,404 |
1,368 |
$83K |
| A4927 |
Non-sterile gloves |
8,066 |
7,719 |
$67K |
| T4522 |
Adult size brief/diaper med |
995 |
980 |
$45K |
| A4335 |
Incontinence supply |
8,576 |
8,451 |
$32K |
| T4525 |
Adult size pull-on sm |
952 |
932 |
$26K |
| T4537 |
Reusable underpad bed size |
929 |
922 |
$23K |
| A4670 |
Automatic bp monitor, dial |
179 |
176 |
$13K |
| T4536 |
Reusable pull-on any size |
1,461 |
1,439 |
$11K |
| T4544 |
Adlt disp und/pull on abv xl |
25 |
24 |
$4K |
| E0607 |
Blood glucose monitor home |
46 |
46 |
$2K |
| A4253 |
Blood glucose/reagent strips |
369 |
350 |
$2K |
| A4259 |
Lancets per box |
360 |
351 |
$437.01 |
| A4245 |
Alcohol wipes per box |
311 |
302 |
$351.07 |
| A4258 |
Lancet device each |
47 |
47 |
$14.12 |