| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4522 |
Adult size brief/diaper med |
27,428 |
27,313 |
$1.01M |
| T4535 |
Disposable liner/shield/pad |
41,885 |
41,723 |
$994K |
| T4523 |
Adult size brief/diaper lg |
10,331 |
10,288 |
$613K |
| A4554 |
Disposable underpads |
23,842 |
23,775 |
$553K |
| T4539 |
Reuse diaper/brief any size |
11,166 |
11,100 |
$302K |
| T4537 |
Reusable underpad bed size |
8,527 |
8,479 |
$264K |
| A4927 |
Non-sterile gloves |
40,308 |
40,196 |
$187K |
| T4521 |
Adult size brief/diaper sm |
4,334 |
4,319 |
$129K |
| T4524 |
Adult size brief/diaper xl |
1,597 |
1,591 |
$128K |
| L3030 |
Foot arch support remov prem |
839 |
820 |
$94K |
| L3217 |
Ladies shoes hightop depth i |
460 |
454 |
$71K |
| L3219 |
Orthopedic mens shoes oxford |
323 |
309 |
$54K |
| A4670 |
Automatic bp monitor, dial |
548 |
536 |
$23K |
| T4540 |
Reusable underpad chair size |
541 |
537 |
$10K |
| L3216 |
Orthoped ladies shoes dpth i |
40 |
40 |
$4K |
| E0240 |
Bath/shower chair |
108 |
108 |
$3K |
| L3221 |
Orthopedic mens shoes dpth i |
13 |
13 |
$1K |