| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
26,934 |
25,237 |
$2.02M |
| T4526 |
Adult size pull-on med |
14,274 |
13,351 |
$1.35M |
| T4541 |
Large disposable underpad |
28,410 |
26,783 |
$1.32M |
| T4527 |
Adult size pull-on lg |
13,225 |
12,370 |
$1.25M |
| T4528 |
Adult size pull-on xl |
6,690 |
6,256 |
$663K |
| T4525 |
Adult size pull-on sm |
3,589 |
3,368 |
$323K |
| T4523 |
Adult size brief/diaper lg |
1,161 |
1,080 |
$129K |
| T4543 |
Adult disp brief/diap abv xl |
744 |
641 |
$126K |
| K0004 |
High strength ltwt whlchr |
2,069 |
1,940 |
$114K |
| E0240 |
Bath/shower chair |
1,664 |
1,610 |
$108K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,772 |
1,623 |
$87K |
| T4544 |
Adlt disp und/pull on abv xl |
864 |
844 |
$87K |
| T4522 |
Adult size brief/diaper med |
676 |
655 |
$67K |
| E0570 |
Nebulizer with compression |
774 |
749 |
$61K |
| T4530 |
Ped size brief/diaper lg |
515 |
468 |
$60K |
| E0247 |
Trans bench w/wo comm open |
505 |
484 |
$56K |
| T2028 |
Special supply, nos waiver |
1,314 |
1,080 |
$54K |
| T4532 |
Ped size pull-on lg |
292 |
284 |
$39K |
| E0244 |
Toilet seat raised |
690 |
679 |
$37K |
| T4524 |
Adult size brief/diaper xl |
265 |
262 |
$27K |
| E0241 |
Bath tub wall rail |
899 |
830 |
$26K |
| T4534 |
Youth size pull-on |
233 |
223 |
$26K |
| K0001 |
Standard wheelchair |
991 |
888 |
$21K |
| E0143 |
Walker folding wheeled w/o s |
520 |
471 |
$17K |
| K0195 |
Elevating whlchair leg rests |
927 |
864 |
$8K |
| A4927 |
Non-sterile gloves |
355 |
331 |
$6K |
| E1399 |
Durable medical equipment mi |
163 |
151 |
$6K |
| A7003 |
Nebulizer administration set |
771 |
748 |
$2K |
| E0156 |
Walker seat attachment |
134 |
122 |
$2K |
| E0243 |
Toilet rail |
12 |
12 |
$715.80 |
| E0246 |
Transfer tub rail attachment |
13 |
13 |
$585.13 |