| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult size pull-on med |
4,369 |
4,206 |
$379K |
| T4527 |
Adult size pull-on lg |
4,080 |
3,878 |
$366K |
| T4528 |
Adult size pull-on xl |
2,791 |
2,629 |
$258K |
| T4541 |
Large disposable underpad |
5,377 |
5,245 |
$251K |
| A4927 |
Non-sterile gloves |
8,131 |
8,039 |
$204K |
| T4535 |
Disposable liner/shield/pad |
5,701 |
5,493 |
$165K |
| B4150 |
Ef complet w/intact nutrient |
1,524 |
1,429 |
$158K |
| T4544 |
Adlt disp und/pull on abv xl |
1,411 |
1,340 |
$134K |
| T4522 |
Adult size brief/diaper med |
972 |
923 |
$107K |
| T4537 |
Reusable underpad bed size |
1,317 |
1,303 |
$76K |
| T4523 |
Adult size brief/diaper lg |
764 |
724 |
$71K |
| T4534 |
Youth size pull-on |
328 |
315 |
$36K |
| T4540 |
Reusable underpad chair size |
940 |
934 |
$35K |
| A4351 |
Straight tip urine catheter |
347 |
337 |
$34K |
| A5131 |
Appliance cleaner |
2,199 |
2,172 |
$26K |
| A4357 |
Bedside drainage bag |
1,464 |
1,432 |
$12K |
| T4525 |
Adult size pull-on sm |
122 |
119 |
$10K |
| B4152 |
Ef calorie dense>/=1.5kcal |
51 |
49 |
$8K |
| A4322 |
Irrigation syringe |
109 |
106 |
$8K |
| A4338 |
Indwelling catheter latex |
466 |
459 |
$5K |
| A4310 |
Insert tray w/o bag/cath |
588 |
584 |
$4K |
| A4358 |
Urinary leg or abdomen bag |
645 |
634 |
$3K |
| A4334 |
Urinary cath leg strap |
857 |
848 |
$2K |
| A6530 |
Compression stocking bk18-30 |
13 |
12 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
145 |
139 |
$943.73 |
| A4402 |
Lubricant per ounce |
165 |
162 |
$674.87 |
| A4245 |
Alcohol wipes per box |
26 |
24 |
$138.28 |
| A5120 |
Skin barrier, wipe or swab |
13 |
12 |
$125.30 |