| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads |
12,354 |
12,247 |
$591K |
| T4523 |
Adult size brief/diaper lg |
4,431 |
4,387 |
$307K |
| T4524 |
Adult size brief/diaper xl |
2,792 |
2,771 |
$220K |
| T4522 |
Adult size brief/diaper med |
3,897 |
3,834 |
$202K |
| T4535 |
Disposable liner/shield/pad |
8,318 |
8,117 |
$193K |
| T4543 |
Adult disp brief/diap abv xl |
778 |
774 |
$119K |
| A4335 |
Incontinence supply |
4,953 |
4,520 |
$101K |
| T4537 |
Reusable underpad bed size |
4,330 |
4,293 |
$92K |
| A4927 |
Non-sterile gloves |
11,606 |
11,406 |
$70K |
| A5120 |
Skin barrier, wipe or swab |
3,443 |
3,101 |
$50K |
| B4150 |
Ef complet w/intact nutrient |
564 |
561 |
$49K |
| A6250 |
Skin seal protect moisturizr |
4,895 |
4,845 |
$43K |
| A4253 |
Blood glucose/reagent strips |
477 |
474 |
$25K |
| T4527 |
Adult size pull-on lg |
785 |
779 |
$25K |
| T4526 |
Adult size pull-on med |
756 |
748 |
$23K |
| T4528 |
Adult size pull-on xl |
470 |
469 |
$19K |
| K0739 |
Repair/svc dme non-oxygen eq |
455 |
412 |
$19K |
| T4521 |
Adult size brief/diaper sm |
398 |
394 |
$18K |
| T4541 |
Large disposable underpad |
400 |
398 |
$10K |
| E1399 |
Durable medical equipment mi |
241 |
234 |
$10K |
| T4539 |
Reuse diaper/brief any size |
319 |
316 |
$8K |
| T4540 |
Reusable underpad chair size |
517 |
507 |
$7K |
| B4154 |
Ef spec metabolic noninherit |
38 |
37 |
$6K |
| E0241 |
Bath tub wall rail |
222 |
182 |
$5K |
| E0240 |
Bath/shower chair |
210 |
207 |
$4K |
| T4525 |
Adult size pull-on sm |
86 |
86 |
$4K |
| A4402 |
Lubricant per ounce |
586 |
388 |
$3K |
| A4670 |
Automatic bp monitor, dial |
138 |
136 |
$3K |
| E0243 |
Toilet rail |
136 |
99 |
$3K |
| A4259 |
Lancets per box |
457 |
455 |
$3K |
| A4245 |
Alcohol wipes per box |
516 |
514 |
$834.18 |
| E0244 |
Toilet seat raised |
66 |
65 |
$829.81 |
| E0143 |
Walker folding wheeled w/o s |
59 |
58 |
$691.85 |
| E0163 |
Commode chair with fixed arm |
14 |
14 |
$266.45 |
| E0156 |
Walker seat attachment |
64 |
64 |
$250.78 |
| E0100 |
Cane adjust/fixed with tip |
13 |
13 |
$28.38 |