| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4534 |
Youth size pull-on |
1,461 |
1,426 |
$245K |
| T4527 |
Adult size pull-on lg |
1,486 |
1,468 |
$167K |
| E0570 |
Nebulizer with compression |
873 |
851 |
$149K |
| T4528 |
Adult size pull-on xl |
1,377 |
1,343 |
$144K |
| T4526 |
Adult size pull-on med |
1,028 |
996 |
$119K |
| T4535 |
Disposable liner/shield/pad |
1,349 |
1,320 |
$87K |
| T4543 |
Adult disp brief/diap abv xl |
311 |
309 |
$75K |
| T4541 |
Large disposable underpad |
756 |
737 |
$36K |
| T4533 |
Youth size brief/diaper |
100 |
98 |
$14K |
| T4537 |
Reusable underpad bed size |
271 |
260 |
$11K |
| A4670 |
Automatic bp monitor, dial |
132 |
131 |
$8K |
| A4927 |
Non-sterile gloves |
228 |
226 |
$4K |
| A5500 |
Diab shoe for density insert |
28 |
15 |
$803.54 |
| A5512 |
Multi den insert direct form |
22 |
12 |
$278.26 |