| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult size brief/diaper xl |
2,254 |
2,226 |
$257K |
| T4523 |
Adult size brief/diaper lg |
2,175 |
2,149 |
$223K |
| A4554 |
Disposable underpads |
4,122 |
4,064 |
$206K |
| T4522 |
Adult size brief/diaper med |
2,362 |
2,333 |
$187K |
| S5185 |
Med reminder serv per month |
487 |
475 |
$128K |
| E0570 |
Nebulizer with compression |
2,393 |
2,369 |
$89K |
| T4535 |
Disposable liner/shield/pad |
1,269 |
1,252 |
$43K |
| E0603 |
Electric breast pump |
248 |
247 |
$36K |
| L3908 |
Who cock-up nonmolde pre ots |
918 |
694 |
$34K |
| A4351 |
Straight tip urine catheter |
142 |
140 |
$21K |
| T4537 |
Reusable underpad bed size |
713 |
703 |
$21K |
| L0625 |
Lo flex l1-below l5 pre ots |
560 |
558 |
$20K |
| L2116 |
Afo tibial fracture rigid |
90 |
89 |
$19K |
| A6530 |
Compression stocking bk18-30 |
556 |
298 |
$19K |
| A4670 |
Automatic bp monitor, dial |
232 |
231 |
$11K |
| A4357 |
Bedside drainage bag |
282 |
275 |
$8K |
| E0143 |
Walker folding wheeled w/o s |
126 |
124 |
$7K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
104 |
103 |
$5K |
| A4425 |
Ost pch drain for barrier fl |
73 |
72 |
$4K |
| A5063 |
Drain ostomy pouch w/flange |
77 |
77 |
$3K |
| E0156 |
Walker seat attachment |
125 |
123 |
$2K |
| A4927 |
Non-sterile gloves |
163 |
158 |
$719.92 |
| A4406 |
Pectin based ostomy paste |
65 |
64 |
$614.35 |
| A4362 |
Solid skin barrier |
12 |
12 |
$580.83 |
| E0240 |
Bath/shower chair |
15 |
14 |
$483.56 |
| A4358 |
Urinary leg or abdomen bag |
40 |
39 |
$467.93 |
| A4394 |
Ostomy pouch liq deodorant |
24 |
24 |
$329.77 |
| A6402 |
Sterile gauze <= 16 sq in |
26 |
26 |
$285.04 |
| A5120 |
Skin barrier, wipe or swab |
24 |
24 |
$168.80 |