| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4150 |
Ef complet w/intact nutrient |
1,850 |
1,651 |
$159K |
| T4527 |
Adult size pull-on lg |
2,004 |
1,957 |
$126K |
| T4526 |
Adult size pull-on med |
2,014 |
1,955 |
$109K |
| T4528 |
Adult size pull-on xl |
1,414 |
1,386 |
$93K |
| T4535 |
Disposable liner/shield/pad |
2,336 |
2,251 |
$86K |
| T4541 |
Large disposable underpad |
2,314 |
2,261 |
$73K |
| E0570 |
Nebulizer with compression |
1,429 |
1,378 |
$66K |
| A5500 |
Diab shoe for density insert |
1,579 |
1,317 |
$64K |
| A5512 |
Multi den insert direct form |
1,697 |
1,300 |
$54K |
| A4670 |
Automatic bp monitor, dial |
1,597 |
1,559 |
$54K |
| T4543 |
Adult disp brief/diap abv xl |
177 |
176 |
$32K |
| A6530 |
Compression stocking bk18-30 |
552 |
483 |
$22K |
| L3908 |
Who cock-up nonmolde pre ots |
555 |
449 |
$14K |
| A4927 |
Non-sterile gloves |
585 |
569 |
$7K |
| T4525 |
Adult size pull-on sm |
110 |
108 |
$5K |
| E0143 |
Walker folding wheeled w/o s |
141 |
137 |
$5K |
| A6402 |
Sterile gauze <= 16 sq in |
340 |
323 |
$3K |
| E0561 |
Humidifier nonheated w pap |
43 |
43 |
$2K |
| A7005 |
Nondisposable nebulizer set |
89 |
88 |
$1K |
| E0100 |
Cane adjust/fixed with tip |
164 |
160 |
$1K |
| E0156 |
Walker seat attachment |
101 |
99 |
$860.97 |
| A4452 |
Waterproof tape |
24 |
24 |
$218.54 |
| A6454 |
Self-adher band w>=3" <5"/yd |
39 |
29 |
$114.21 |
| A6446 |
Conform band s w>=3" <5"/yd |
12 |
12 |
$107.61 |
| A4450 |
Non-waterproof tape |
13 |
12 |
$30.72 |