| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
3,488 |
3,452 |
$108K |
| T4523 |
Adult size brief/diaper lg |
1,134 |
1,123 |
$87K |
| A4554 |
Disposable underpads |
2,465 |
2,447 |
$80K |
| T4524 |
Adult size brief/diaper xl |
698 |
694 |
$59K |
| T4522 |
Adult size brief/diaper med |
876 |
867 |
$44K |
| T4543 |
Adult disp brief/diap abv xl |
205 |
200 |
$28K |
| A4927 |
Non-sterile gloves |
2,580 |
2,567 |
$11K |
| T4521 |
Adult size brief/diaper sm |
253 |
249 |
$10K |
| E0241 |
Bath tub wall rail |
275 |
275 |
$9K |
| T4537 |
Reusable underpad bed size |
322 |
317 |
$9K |
| A4253 |
Blood glucose/reagent strips |
232 |
226 |
$7K |
| K0739 |
Repair/svc dme non-oxygen eq |
310 |
308 |
$7K |
| E0240 |
Bath/shower chair |
117 |
117 |
$4K |
| A4259 |
Lancets per box |
252 |
249 |
$3K |
| T4539 |
Reuse diaper/brief any size |
93 |
93 |
$2K |
| B4150 |
Ef complet w/intact nutrient |
54 |
53 |
$1K |
| E0243 |
Toilet rail |
30 |
30 |
$932.62 |
| K0001 |
Standard wheelchair |
39 |
39 |
$741.13 |
| E0246 |
Transfer tub rail attachment |
14 |
14 |
$673.40 |
| E0244 |
Toilet seat raised |
33 |
33 |
$524.75 |
| A4245 |
Alcohol wipes per box |
225 |
222 |
$353.15 |
| A4258 |
Lancet device each |
16 |
16 |
$52.27 |