| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6250 |
Skin seal protect moisturizr |
27,101 |
25,237 |
$11.92M |
| A4554 |
Disposable underpads |
14,328 |
13,489 |
$957K |
| A4927 |
Non-sterile gloves |
22,289 |
20,902 |
$816K |
| A4245 |
Alcohol wipes per box |
3,272 |
3,122 |
$725K |
| T4543 |
Adult disp brief/diap abv xl |
3,186 |
3,023 |
$613K |
| T4535 |
Disposable liner/shield/pad |
8,167 |
7,688 |
$606K |
| T4524 |
Adult size brief/diaper xl |
4,607 |
4,345 |
$586K |
| A6260 |
Wound cleanser any type/size |
9,992 |
9,375 |
$573K |
| T4523 |
Adult size brief/diaper lg |
4,727 |
4,445 |
$546K |
| T4521 |
Adult size brief/diaper sm |
2,362 |
2,250 |
$213K |
| T4522 |
Adult size brief/diaper med |
1,880 |
1,812 |
$177K |
| A4772 |
Blood glucose test strips |
601 |
563 |
$90K |
| T4530 |
Ped size brief/diaper lg |
301 |
290 |
$30K |
| A4452 |
Waterproof tape |
483 |
453 |
$29K |
| A6402 |
Sterile gauze <= 16 sq in |
563 |
531 |
$18K |
| A4928 |
Surgical mask |
1,261 |
1,202 |
$15K |
| A4244 |
Alcohol or peroxide per pint |
2,620 |
2,463 |
$12K |
| A5120 |
Skin barrier, wipe or swab |
1,178 |
1,017 |
$11K |
| T4529 |
Ped size brief/diaper sm/med |
98 |
91 |
$10K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
68 |
63 |
$5K |
| E0570 |
Nebulizer with compression |
136 |
125 |
$4K |
| A4371 |
Skin barrier powder per oz |
332 |
317 |
$3K |
| A4670 |
Automatic bp monitor, dial |
25 |
25 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
260 |
231 |
$2K |
| A4259 |
Lancets per box |
616 |
586 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
32 |
25 |
$1K |
| E0156 |
Walker seat attachment |
34 |
27 |
$338.71 |
| A4335 |
Incontinence supply |
360 |
357 |
$0.00 |