| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
35,907 |
35,853 |
$2.51M |
| T4526 |
Adult size pull-on med |
11,547 |
11,542 |
$1.68M |
| T4527 |
Adult size pull-on lg |
12,739 |
12,719 |
$1.65M |
| T4528 |
Adult size pull-on xl |
8,449 |
8,437 |
$1.47M |
| T4535 |
Disposable liner/shield/pad |
26,357 |
26,318 |
$1.27M |
| T4544 |
Adlt disp und/pull on abv xl |
2,596 |
2,590 |
$684K |
| T4524 |
Adult size brief/diaper xl |
1,420 |
1,420 |
$212K |
| T4523 |
Adult size brief/diaper lg |
1,725 |
1,724 |
$190K |
| E0240 |
Bath/shower chair |
1,772 |
1,769 |
$181K |
| T4525 |
Adult size pull-on sm |
1,288 |
1,277 |
$133K |
| T4543 |
Adult disp brief/diap abv xl |
292 |
292 |
$78K |
| T4522 |
Adult size brief/diaper med |
711 |
711 |
$76K |
| A4670 |
Automatic bp monitor, dial |
1,231 |
1,227 |
$75K |
| A5500 |
Diab shoe for density insert |
902 |
729 |
$25K |
| A5512 |
Multi den insert direct form |
902 |
729 |
$23K |
| E0607 |
Blood glucose monitor home |
821 |
821 |
$15K |
| A4927 |
Non-sterile gloves |
819 |
818 |
$13K |
| E0247 |
Trans bench w/wo comm open |
33 |
33 |
$3K |
| A4253 |
Blood glucose/reagent strips |
851 |
851 |
$3K |
| E0246 |
Transfer tub rail attachment |
49 |
49 |
$3K |
| E0105 |
Cane adjust/fixed quad/3 pro |
80 |
80 |
$1K |
| E0163 |
Commode chair with fixed arm |
42 |
42 |
$379.69 |
| A4258 |
Lancet device each |
581 |
581 |
$275.80 |
| A4259 |
Lancets per box |
862 |
862 |
$267.47 |