| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
23,863 |
23,793 |
$1.26M |
| T4535 |
Disposable liner/shield/pad |
13,192 |
13,153 |
$800K |
| T4527 |
Adult size pull-on lg |
6,458 |
6,453 |
$501K |
| T4526 |
Adult size pull-on med |
5,030 |
5,018 |
$298K |
| A6250 |
Skin seal protect moisturizr |
13,000 |
12,985 |
$200K |
| T4523 |
Adult size brief/diaper lg |
1,943 |
1,937 |
$186K |
| A4335 |
Incontinence supply |
14,117 |
14,107 |
$182K |
| T4536 |
Reusable pull-on any size |
9,666 |
9,642 |
$113K |
| T4537 |
Reusable underpad bed size |
3,559 |
3,554 |
$108K |
| T4522 |
Adult size brief/diaper med |
896 |
896 |
$88K |
| K0001 |
Standard wheelchair |
525 |
525 |
$8K |
| A4253 |
Blood glucose/reagent strips |
991 |
945 |
$7K |
| K0003 |
Lightweight wheelchair |
251 |
251 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
95 |
94 |
$2K |
| A4259 |
Lancets per box |
987 |
943 |
$332.08 |
| A4258 |
Lancet device each |
14 |
14 |
$6.74 |