| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
10,969 |
8,472 |
$569K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
4,429 |
3,328 |
$485K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
3,313 |
2,483 |
$404K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
6,465 |
4,871 |
$365K |
| A4927 |
Gloves, non-sterile, per 100 |
14,359 |
11,043 |
$306K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,605 |
1,174 |
$293K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
12,088 |
9,008 |
$282K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,320 |
1,811 |
$198K |
| A5120 |
Skin barrier, wipes or swabs, each |
15,025 |
11,255 |
$115K |
| A6260 |
Wound cleansers, any type, any size |
3,174 |
2,723 |
$39K |
| A4928 |
Surgical mask, per 20 |
2,053 |
1,766 |
$16K |
| A4245 |
Alcohol wipes, per box |
1,830 |
1,642 |
$11K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
103 |
88 |
$4K |
| A4244 |
Alcohol or peroxide, per pint |
2,118 |
1,714 |
$2K |
| E0156 |
Seat attachment, walker |
38 |
38 |
$0.00 |