| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads |
56,426 |
22,504 |
$692K |
| T4527 |
Adult size pull-on lg |
15,417 |
7,165 |
$672K |
| T4528 |
Adult size pull-on xl |
16,580 |
6,001 |
$595K |
| T4524 |
Adult size brief/diaper xl |
16,092 |
5,203 |
$516K |
| T4523 |
Adult size brief/diaper lg |
11,223 |
4,999 |
$475K |
| T4526 |
Adult size pull-on med |
21,233 |
6,176 |
$453K |
| T4543 |
Adult disp brief/diap abv xl |
6,933 |
2,367 |
$414K |
| T4544 |
Adlt disp und/pull on abv xl |
5,286 |
2,285 |
$238K |
| B4035 |
Enteral feed supp pump per d |
17,387 |
1,695 |
$224K |
| T4522 |
Adult size brief/diaper med |
14,277 |
2,955 |
$223K |
| A4305 |
Drug delivery system >=50 ml |
9,417 |
1,205 |
$219K |
| A4351 |
Straight tip urine catheter |
7,460 |
849 |
$136K |
| A4221 |
Supp non-insulin inf cath/wk |
10,114 |
2,292 |
$79K |
| A4222 |
Infusion supplies with pump |
1,181 |
265 |
$70K |
| A9999 |
Dme supply or accessory, nos |
20,046 |
9,938 |
$65K |
| A4927 |
Non-sterile gloves |
19,780 |
9,808 |
$60K |
| B4034 |
Enter feed supkit syr by day |
3,025 |
764 |
$53K |
| T4525 |
Adult size pull-on sm |
3,340 |
800 |
$47K |
| T4529 |
Ped size brief/diaper sm/med |
7,526 |
615 |
$47K |
| B9998 |
Enteral supp not otherwise c |
7,026 |
955 |
$41K |
| A4216 |
Sterile water/saline, 10 ml |
9,602 |
1,497 |
$25K |
| A6250 |
Skin seal protect moisturizr |
6,470 |
4,467 |
$14K |
| T4521 |
Adult size brief/diaper sm |
277 |
166 |
$11K |
| A4332 |
Lube sterile packet |
2,778 |
433 |
$5K |
| J2260 |
Inj milrinone lactate / 5 mg |
133 |
37 |
$4K |
| T4532 |
Ped size pull-on lg |
1,148 |
48 |
$3K |
| J1642 |
Inj heparin sodium per 10 u |
6,973 |
1,144 |
$2K |
| B9002 |
Enter nutr inf pump any type |
14 |
12 |
$568.16 |