| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6250 |
Skin seal protect moisturizr |
28,119 |
26,181 |
$9.34M |
| T4535 |
Disposable liner/shield/pad |
16,811 |
16,291 |
$1.11M |
| A4554 |
Disposable underpads |
21,481 |
20,639 |
$1.00M |
| T4523 |
Adult size brief/diaper lg |
7,422 |
7,202 |
$747K |
| T4524 |
Adult size brief/diaper xl |
6,712 |
6,535 |
$650K |
| T4543 |
Adult disp brief/diap abv xl |
3,296 |
3,179 |
$524K |
| A4927 |
Non-sterile gloves |
28,065 |
27,191 |
$476K |
| A4772 |
Blood glucose test strips |
2,500 |
2,438 |
$337K |
| A5120 |
Skin barrier, wipe or swab |
29,149 |
28,306 |
$332K |
| T4522 |
Adult size brief/diaper med |
4,619 |
4,501 |
$323K |
| T4521 |
Adult size brief/diaper sm |
422 |
416 |
$25K |
| A4245 |
Alcohol wipes per box |
2,675 |
2,601 |
$19K |
| A5131 |
Appliance cleaner |
631 |
553 |
$9K |
| A4670 |
Automatic bp monitor, dial |
68 |
64 |
$7K |
| T4528 |
Adult size pull-on xl |
54 |
53 |
$4K |
| A4452 |
Waterproof tape |
124 |
120 |
$4K |
| S5199 |
Personal care item nos each |
175 |
173 |
$4K |
| A4259 |
Lancets per box |
2,051 |
2,002 |
$3K |
| A7030 |
Cpap full face mask |
24 |
24 |
$2K |
| A6260 |
Wound cleanser any type/size |
25 |
25 |
$1K |
| T4542 |
Small disposable underpad |
12 |
12 |
$490.00 |