| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
9,402 |
9,398 |
$330K |
| T4522 |
Adult size brief/diaper med |
5,519 |
5,517 |
$262K |
| T4523 |
Adult size brief/diaper lg |
2,635 |
2,632 |
$187K |
| A4554 |
Disposable underpads |
3,977 |
3,977 |
$130K |
| T4537 |
Reusable underpad bed size |
1,288 |
1,286 |
$32K |
| T4539 |
Reuse diaper/brief any size |
1,188 |
1,188 |
$26K |
| A4927 |
Non-sterile gloves |
4,861 |
4,844 |
$22K |
| T4521 |
Adult size brief/diaper sm |
186 |
186 |
$9K |
| A4335 |
Incontinence supply |
1,407 |
1,404 |
$7K |
| A4402 |
Lubricant per ounce |
171 |
171 |
$3K |
| E0570 |
Nebulizer with compression |
24 |
24 |
$2K |
| A4670 |
Automatic bp monitor, dial |
12 |
12 |
$600.00 |
| E1399 |
Durable medical equipment mi |
79 |
79 |
$506.70 |
| A4259 |
Lancets per box |
24 |
24 |
$170.28 |