| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
27,101 |
25,237 |
$11.92M |
| A4554 |
Disposable underpads, all sizes |
14,328 |
13,489 |
$957K |
| A4927 |
Gloves, non-sterile, per 100 |
22,289 |
20,902 |
$816K |
| A4245 |
Alcohol wipes, per box |
3,272 |
3,122 |
$725K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
3,186 |
3,023 |
$613K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
8,167 |
7,688 |
$606K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
4,607 |
4,345 |
$586K |
| A6260 |
Wound cleansers, any type, any size |
9,992 |
9,375 |
$573K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
4,727 |
4,445 |
$546K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
2,362 |
2,250 |
$213K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,880 |
1,812 |
$177K |
| A4772 |
Blood glucose test strips, for dialysis, per 50 |
601 |
563 |
$90K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
301 |
290 |
$30K |
| A4452 |
Tape, waterproof, per 18 square inches |
483 |
453 |
$29K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
563 |
531 |
$18K |
| A4928 |
Surgical mask, per 20 |
1,261 |
1,202 |
$15K |
| A4244 |
Alcohol or peroxide, per pint |
2,620 |
2,463 |
$12K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,178 |
1,017 |
$11K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
98 |
91 |
$10K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
68 |
63 |
$5K |
| E0570 |
Nebulizer, with compressor |
136 |
125 |
$4K |
| A4371 |
Ostomy skin barrier, powder, per oz |
332 |
317 |
$3K |
| A4670 |
Automatic blood pressure monitor |
25 |
25 |
$2K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
260 |
231 |
$2K |
| A4259 |
Lancets, per box of 100 |
616 |
586 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
32 |
25 |
$1K |
| E0156 |
Seat attachment, walker |
34 |
27 |
$338.71 |
| A4335 |
Incontinence supply; miscellaneous |
360 |
357 |
$0.00 |