| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
52,176 |
52,064 |
$4.73M |
| L3030 |
Foot arch support remov prem |
21,439 |
20,367 |
$2.44M |
| T4535 |
Disposable liner/shield/pad |
72,176 |
72,023 |
$2.34M |
| T4522 |
Adult size brief/diaper med |
41,169 |
41,093 |
$2.29M |
| A4554 |
Disposable underpads |
67,612 |
67,482 |
$2.25M |
| T4539 |
Reuse diaper/brief any size |
51,310 |
51,197 |
$1.20M |
| T4537 |
Reusable underpad bed size |
31,611 |
31,540 |
$850K |
| L3216 |
Orthoped ladies shoes dpth i |
8,348 |
7,863 |
$672K |
| L3221 |
Orthopedic mens shoes dpth i |
5,697 |
5,344 |
$533K |
| L3217 |
Ladies shoes hightop depth i |
3,193 |
3,124 |
$459K |
| L3222 |
Mens shoes hightop depth inl |
1,981 |
1,925 |
$331K |
| L3215 |
Orthopedic ftwear ladies oxf |
2,465 |
2,405 |
$328K |
| T4524 |
Adult size brief/diaper xl |
3,442 |
3,437 |
$299K |
| T4521 |
Adult size brief/diaper sm |
4,309 |
4,300 |
$191K |
| L3219 |
Orthopedic mens shoes oxford |
1,211 |
1,166 |
$187K |
| A6530 |
Compression stocking bk18-30 |
5,044 |
4,770 |
$183K |
| A4927 |
Non-sterile gloves |
24,895 |
24,859 |
$116K |
| L3020 |
Foot longitud/metatarsal sup |
128 |
128 |
$29K |
| A4670 |
Automatic bp monitor, dial |
630 |
628 |
$28K |
| E0240 |
Bath/shower chair |
297 |
296 |
$10K |
| A6533 |
Gc stocking thighlngth 18-30 |
133 |
131 |
$5K |
| A5120 |
Skin barrier, wipe or swab |
195 |
195 |
$4K |
| T4540 |
Reusable underpad chair size |
228 |
228 |
$3K |
| A6539 |
Gc stocking waistlngth 18-30 |
33 |
33 |
$3K |
| L3050 |
Foot arch supp premold metat |
12 |
12 |
$721.44 |