| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
7,870 |
5,974 |
$389K |
| T2028 |
Special supply, nos waiver |
4,009 |
3,353 |
$301K |
| T4528 |
Adult size pull-on xl |
5,424 |
3,844 |
$264K |
| T4526 |
Adult size pull-on med |
5,529 |
4,044 |
$220K |
| T4524 |
Adult size brief/diaper xl |
2,562 |
1,902 |
$189K |
| T4535 |
Disposable liner/shield/pad |
6,848 |
5,049 |
$174K |
| B4035 |
Enteral feed supp pump per d |
3,722 |
2,695 |
$159K |
| T4522 |
Adult size brief/diaper med |
1,201 |
920 |
$92K |
| T4523 |
Adult size brief/diaper lg |
690 |
586 |
$85K |
| B4150 |
Ef complet w/intact nutrient |
2,821 |
2,063 |
$80K |
| S9977 |
Meals per diem |
975 |
793 |
$63K |
| T4541 |
Large disposable underpad |
2,405 |
1,997 |
$47K |
| T2029 |
Special med equip, noswaiver |
3,664 |
1,805 |
$41K |
| T4543 |
Adult disp brief/diap abv xl |
202 |
147 |
$25K |
| B4152 |
Ef calorie dense>/=1.5kcal |
690 |
465 |
$24K |
| A4335 |
Incontinence supply |
1,115 |
870 |
$15K |
| A4314 |
Cath w/drainage 2-way latex |
1,338 |
1,276 |
$11K |
| A4357 |
Bedside drainage bag |
2,141 |
1,930 |
$10K |
| T4544 |
Adlt disp und/pull on abv xl |
114 |
76 |
$6K |
| A4623 |
Tracheostomy inner cannula |
244 |
222 |
$6K |
| A4927 |
Non-sterile gloves |
90 |
69 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
267 |
254 |
$1K |
| A4334 |
Urinary cath leg strap |
482 |
468 |
$843.63 |
| T4542 |
Small disposable underpad |
16 |
15 |
$519.84 |
| B9002 |
Enter nutr inf pump any type |
39 |
38 |
$283.00 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
26 |
24 |
$127.42 |
| A4629 |
Tracheostomy care kit |
166 |
156 |
$92.72 |
| A4338 |
Indwelling catheter latex |
14 |
13 |
$51.63 |
| A4310 |
Insert tray w/o bag/cath |
14 |
14 |
$31.49 |
| A7526 |
Tracheostomy tube collar |
72 |
69 |
$0.00 |