| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
10,671 |
7,445 |
$977K |
| T4528 |
Adult size pull-on xl |
4,676 |
4,122 |
$479K |
| T4541 |
Large disposable underpad |
12,229 |
11,193 |
$465K |
| T4527 |
Adult size pull-on lg |
4,886 |
4,395 |
$443K |
| T4526 |
Adult size pull-on med |
4,003 |
3,637 |
$337K |
| B4150 |
Ef complet w/intact nutrient |
3,014 |
2,533 |
$276K |
| T4535 |
Disposable liner/shield/pad |
7,813 |
6,719 |
$252K |
| T4537 |
Reusable underpad bed size |
2,001 |
1,766 |
$207K |
| T4523 |
Adult size brief/diaper lg |
2,257 |
1,876 |
$186K |
| A4927 |
Non-sterile gloves |
10,827 |
9,952 |
$167K |
| T4522 |
Adult size brief/diaper med |
1,723 |
1,434 |
$149K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,146 |
871 |
$131K |
| T4524 |
Adult size brief/diaper xl |
1,375 |
1,200 |
$126K |
| T4525 |
Adult size pull-on sm |
1,435 |
1,226 |
$100K |
| T4540 |
Reusable underpad chair size |
1,920 |
1,702 |
$96K |
| T4544 |
Adlt disp und/pull on abv xl |
416 |
401 |
$93K |
| B4154 |
Ef spec metabolic noninherit |
337 |
304 |
$60K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,557 |
1,292 |
$46K |
| T1999 |
Noc retail items andsupplies |
440 |
309 |
$31K |
| T4536 |
Reusable pull-on any size |
206 |
184 |
$23K |
| A4351 |
Straight tip urine catheter |
283 |
239 |
$11K |
| E0570 |
Nebulizer with compression |
723 |
689 |
$6K |
| E0601 |
Cont airway pressure device |
121 |
105 |
$5K |
| K0553 |
Ther cgm supply allowance |
53 |
53 |
$4K |
| T4543 |
Adult disp brief/diap abv xl |
14 |
12 |
$4K |
| A4670 |
Automatic bp monitor, dial |
64 |
63 |
$3K |
| A4357 |
Bedside drainage bag |
433 |
359 |
$2K |
| K0001 |
Standard wheelchair |
111 |
97 |
$1K |
| E0245 |
Tub stool or bench |
14 |
14 |
$621.00 |
| A4253 |
Blood glucose/reagent strips |
96 |
77 |
$339.55 |
| A4259 |
Lancets per box |
76 |
65 |
$30.76 |