| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads |
10,969 |
8,472 |
$569K |
| T4523 |
Adult size brief/diaper lg |
4,429 |
3,328 |
$485K |
| T4524 |
Adult size brief/diaper xl |
3,313 |
2,483 |
$404K |
| T4535 |
Disposable liner/shield/pad |
6,465 |
4,871 |
$365K |
| A4927 |
Non-sterile gloves |
14,359 |
11,043 |
$306K |
| T4543 |
Adult disp brief/diap abv xl |
1,605 |
1,174 |
$293K |
| A6250 |
Skin seal protect moisturizr |
12,088 |
9,008 |
$282K |
| T4522 |
Adult size brief/diaper med |
2,320 |
1,811 |
$198K |
| A5120 |
Skin barrier, wipe or swab |
15,025 |
11,255 |
$115K |
| A6260 |
Wound cleanser any type/size |
3,174 |
2,723 |
$39K |
| A4928 |
Surgical mask |
2,053 |
1,766 |
$16K |
| A4245 |
Alcohol wipes per box |
1,830 |
1,642 |
$11K |
| A4253 |
Blood glucose/reagent strips |
103 |
88 |
$4K |
| A4244 |
Alcohol or peroxide per pint |
2,118 |
1,714 |
$2K |
| E0156 |
Walker seat attachment |
38 |
38 |
$0.00 |