| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult size pull-on xl |
1,571 |
1,436 |
$296K |
| T4527 |
Adult size pull-on lg |
1,031 |
990 |
$196K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
443 |
404 |
$179K |
| T4537 |
Reusable underpad bed size |
4,335 |
4,153 |
$164K |
| T4541 |
Large disposable underpad |
6,197 |
5,817 |
$128K |
| T4526 |
Adult size pull-on med |
479 |
463 |
$86K |
| K0003 |
Lightweight wheelchair |
970 |
936 |
$31K |
| A4927 |
Non-sterile gloves |
1,726 |
1,704 |
$28K |
| T4544 |
Adlt disp und/pull on abv xl |
101 |
79 |
$23K |
| E0570 |
Nebulizer with compression |
605 |
542 |
$18K |
| A4385 |
Ost skn barrier sld ext wear |
92 |
85 |
$4K |
| A7006 |
Filtered nebulizer admin set |
78 |
77 |
$662.22 |
| K0195 |
Elevating whlchair leg rests |
110 |
109 |
$645.56 |
| A4660 |
Sphyg/bp app w cuff and stet |
13 |
12 |
$272.68 |
| A7003 |
Nebulizer administration set |
150 |
142 |
$153.87 |