| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
114,908 |
101,470 |
$9.61M |
| A4927 |
Non-sterile gloves |
353,790 |
311,999 |
$9.26M |
| T4528 |
Adult size pull-on xl |
71,322 |
62,746 |
$6.06M |
| T4537 |
Reusable underpad bed size |
151,360 |
129,428 |
$5.51M |
| T4526 |
Adult size pull-on med |
77,404 |
67,282 |
$5.44M |
| T4541 |
Large disposable underpad |
113,849 |
100,043 |
$5.38M |
| T4535 |
Disposable liner/shield/pad |
132,452 |
113,659 |
$3.54M |
| T4543 |
Adult disp brief/diap abv xl |
13,275 |
11,217 |
$3.04M |
| T4524 |
Adult size brief/diaper xl |
29,518 |
25,713 |
$2.76M |
| A4335 |
Incontinence supply |
111,947 |
95,510 |
$2.69M |
| T4544 |
Adlt disp und/pull on abv xl |
16,877 |
14,364 |
$2.53M |
| T4523 |
Adult size brief/diaper lg |
30,287 |
26,492 |
$2.31M |
| T4522 |
Adult size brief/diaper med |
11,053 |
9,583 |
$668K |
| T4525 |
Adult size pull-on sm |
7,400 |
6,459 |
$526K |
| B4150 |
Ef complet w/intact nutrient |
5,181 |
3,051 |
$242K |
| S9999 |
Sales tax |
9,038 |
7,819 |
$84K |
| A4349 |
Disposable male external cat |
1,222 |
835 |
$24K |
| A4357 |
Bedside drainage bag |
3,048 |
2,232 |
$17K |
| T4521 |
Adult size brief/diaper sm |
372 |
270 |
$14K |
| A4239 |
Non-adju cgm supply allow |
505 |
302 |
$13K |
| A4520 |
Incontinence garment anytype |
2,814 |
1,536 |
$6K |
| A4358 |
Urinary leg or abdomen bag |
1,523 |
1,059 |
$5K |
| E2103 |
Non-adju cgm receiver/mon |
56 |
16 |
$2K |
| B4152 |
Ef calorie dense>/=1.5kcal |
16 |
13 |
$1K |
| A4245 |
Alcohol wipes per box |
477 |
334 |
$494.49 |
| A4253 |
Blood glucose/reagent strips |
47 |
26 |
$234.99 |
| A4259 |
Lancets per box |
44 |
25 |
$20.65 |