| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
6,317 |
5,975 |
$205K |
| A4335 |
Incontinence supply |
3,459 |
3,375 |
$134K |
| T4537 |
Reusable underpad bed size |
2,617 |
2,440 |
$110K |
| T4527 |
Adult size pull-on lg |
2,085 |
1,925 |
$102K |
| T4532 |
Ped size pull-on lg |
1,538 |
1,512 |
$101K |
| T4528 |
Adult size pull-on xl |
1,486 |
1,389 |
$96K |
| T4526 |
Adult size pull-on med |
1,817 |
1,724 |
$83K |
| T4534 |
Youth size pull-on |
1,125 |
1,098 |
$75K |
| T4543 |
Adult disp brief/diap abv xl |
550 |
507 |
$62K |
| A4927 |
Non-sterile gloves |
6,784 |
5,909 |
$58K |
| T4544 |
Adlt disp und/pull on abv xl |
547 |
517 |
$58K |
| T4524 |
Adult size brief/diaper xl |
604 |
572 |
$46K |
| T4523 |
Adult size brief/diaper lg |
768 |
745 |
$45K |
| T4522 |
Adult size brief/diaper med |
891 |
863 |
$42K |
| T4535 |
Disposable liner/shield/pad |
2,106 |
1,948 |
$33K |
| T4525 |
Adult size pull-on sm |
461 |
441 |
$27K |
| T4530 |
Ped size brief/diaper lg |
581 |
569 |
$26K |
| A4520 |
Incontinence garment anytype |
1,901 |
1,672 |
$26K |
| T4521 |
Adult size brief/diaper sm |
356 |
352 |
$22K |
| A4554 |
Disposable underpads |
1,905 |
1,668 |
$20K |
| A4351 |
Straight tip urine catheter |
66 |
65 |
$9K |
| T4533 |
Youth size brief/diaper |
37 |
37 |
$3K |
| A4409 |
Ost skn barr convex <=4 sq i |
43 |
40 |
$3K |
| A4385 |
Ost skn barrier sld ext wear |
24 |
24 |
$2K |
| A6212 |
Foam drg <=16 sq in w/border |
12 |
12 |
$1K |
| A4349 |
Disposable male external cat |
29 |
29 |
$1K |
| A4357 |
Bedside drainage bag |
83 |
80 |
$641.67 |
| A4332 |
Lube sterile packet |
30 |
30 |
$319.02 |
| A4344 |
Cath indw foley 2 way silicn |
14 |
14 |
$273.01 |
| A4358 |
Urinary leg or abdomen bag |
35 |
35 |
$271.64 |
| A4452 |
Waterproof tape |
32 |
31 |
$253.41 |
| A6402 |
Sterile gauze <= 16 sq in |
22 |
22 |
$249.88 |
| T4542 |
Small disposable underpad |
13 |
13 |
$244.00 |
| A4394 |
Ostomy pouch liq deodorant |
13 |
13 |
$184.04 |
| A4406 |
Pectin based ostomy paste |
15 |
14 |
$171.54 |
| A4553 |
Nondisp underpads, all sizes |
436 |
400 |
$118.82 |
| A4402 |
Lubricant per ounce |
26 |
24 |
$104.02 |
| A6216 |
Non-sterile gauze<=16 sq in |
18 |
17 |
$91.62 |
| A4456 |
Adhesive remover, wipes |
13 |
13 |
$79.22 |
| A5120 |
Skin barrier, wipe or swab |
44 |
35 |
$74.58 |
| A6250 |
Skin seal protect moisturizr |
79 |
65 |
$50.63 |
| A4371 |
Skin barrier powder per oz |
12 |
12 |
$40.51 |