| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult size pull-on med |
15,118 |
14,969 |
$1.13M |
| T4535 |
Disposable liner/shield/pad |
22,513 |
22,315 |
$723K |
| T4540 |
Reusable underpad chair size |
20,843 |
20,625 |
$646K |
| T4527 |
Adult size pull-on lg |
6,210 |
6,153 |
$597K |
| A4553 |
Nondisp underpads, all sizes |
7,421 |
7,372 |
$263K |
| A4927 |
Non-sterile gloves |
21,040 |
20,077 |
$236K |
| T4541 |
Large disposable underpad |
11,773 |
11,610 |
$195K |
| T4536 |
Reusable pull-on any size |
21,333 |
21,159 |
$175K |
| A4554 |
Disposable underpads |
4,201 |
4,174 |
$143K |
| T4528 |
Adult size pull-on xl |
941 |
928 |
$120K |
| A6533 |
Gc stocking thighlngth 18-30 |
2,942 |
988 |
$79K |
| T4522 |
Adult size brief/diaper med |
920 |
884 |
$76K |
| T4525 |
Adult size pull-on sm |
689 |
687 |
$52K |
| T4523 |
Adult size brief/diaper lg |
202 |
199 |
$24K |
| T4543 |
Adult disp brief/diap abv xl |
38 |
38 |
$11K |
| A6530 |
Compression stocking bk18-30 |
149 |
57 |
$3K |
| K0001 |
Standard wheelchair |
438 |
433 |
$2K |
| A4670 |
Automatic bp monitor, dial |
38 |
38 |
$2K |
| E0240 |
Bath/shower chair |
40 |
39 |
$1K |
| E0260 |
Hosp bed semi-electr w/ matt |
78 |
70 |
$898.65 |
| K0195 |
Elevating whlchair leg rests |
557 |
550 |
$652.05 |
| A5512 |
Multi den insert direct form |
50 |
24 |
$487.96 |
| A5500 |
Diab shoe for density insert |
48 |
23 |
$472.29 |
| E0143 |
Walker folding wheeled w/o s |
16 |
16 |
$250.55 |
| E0156 |
Walker seat attachment |
14 |
14 |
$34.82 |