| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
10,678 |
10,592 |
$363K |
| T4541 |
Large disposable underpad |
11,715 |
11,615 |
$311K |
| T4527 |
Adult size pull-on lg |
5,012 |
4,980 |
$229K |
| T4528 |
Adult size pull-on xl |
1,797 |
1,786 |
$63K |
| T4526 |
Adult size pull-on med |
1,544 |
1,534 |
$48K |
| L0650 |
Lso sc r ant/pos pnl pre ots |
88 |
88 |
$35K |
| T4523 |
Adult size brief/diaper lg |
560 |
559 |
$20K |
| T4524 |
Adult size brief/diaper xl |
146 |
146 |
$11K |
| E1028 |
W/c manual swingaway |
22 |
12 |
$5K |
| E0570 |
Nebulizer with compression |
48 |
47 |
$3K |
| E0277 |
Powered pres-redu air mattrs |
12 |
12 |
$3K |
| E0147 |
Walker variable wheel resist |
40 |
40 |
$2K |
| T4537 |
Reusable underpad bed size |
41 |
41 |
$628.74 |
| A6250 |
Skin seal protect moisturizr |
638 |
625 |
$537.51 |
| A7005 |
Nondisposable nebulizer set |
45 |
44 |
$483.91 |
| E0156 |
Walker seat attachment |
63 |
61 |
$230.56 |
| E0245 |
Tub stool or bench |
12 |
12 |
$49.56 |
| A4335 |
Incontinence supply |
29 |
27 |
$17.43 |
| T4536 |
Reusable pull-on any size |
30 |
30 |
$0.00 |