| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
5,659 |
5,362 |
$326K |
| T4541 |
Large disposable underpad |
6,572 |
6,528 |
$321K |
| A4927 |
Non-sterile gloves |
8,523 |
6,978 |
$250K |
| T5999 |
Supply, nos |
7,902 |
7,794 |
$232K |
| T4527 |
Adult size pull-on lg |
2,726 |
2,715 |
$214K |
| T4528 |
Adult size pull-on xl |
1,464 |
1,456 |
$112K |
| T4526 |
Adult size pull-on med |
1,689 |
1,683 |
$108K |
| T4523 |
Adult size brief/diaper lg |
751 |
748 |
$75K |
| A6250 |
Skin seal protect moisturizr |
5,262 |
5,238 |
$70K |
| T4524 |
Adult size brief/diaper xl |
663 |
655 |
$65K |
| T4525 |
Adult size pull-on sm |
695 |
677 |
$43K |
| T4522 |
Adult size brief/diaper med |
432 |
430 |
$37K |
| A4351 |
Straight tip urine catheter |
171 |
170 |
$36K |
| A4335 |
Incontinence supply |
4,848 |
4,834 |
$31K |
| A4670 |
Automatic bp monitor, dial |
426 |
426 |
$29K |
| T4537 |
Reusable underpad bed size |
526 |
526 |
$14K |
| A4385 |
Ost skn barrier sld ext wear |
105 |
105 |
$10K |
| A4425 |
Ost pch drain for barrier fl |
233 |
232 |
$10K |
| A4419 |
Ost pch for bar w flange/flt |
26 |
26 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
304 |
304 |
$2K |
| A4456 |
Adhesive remover, wipes |
284 |
283 |
$2K |
| A4406 |
Pectin based ostomy paste |
89 |
89 |
$1K |
| A4409 |
Ost skn barr convex <=4 sq i |
12 |
12 |
$828.79 |
| E0163 |
Commode chair with fixed arm |
12 |
12 |
$728.51 |
| A4394 |
Ostomy pouch liq deodorant |
65 |
65 |
$545.01 |