| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
26,713 |
26,669 |
$1.90M |
| T4522 |
Adult size brief/diaper med |
27,525 |
27,453 |
$1.54M |
| A4554 |
Disposable underpads |
52,031 |
51,911 |
$1.39M |
| T4524 |
Adult size brief/diaper xl |
14,525 |
14,482 |
$1.11M |
| E1399 |
Durable medical equipment mi |
4,401 |
4,307 |
$793K |
| T4543 |
Adult disp brief/diap abv xl |
4,406 |
4,391 |
$648K |
| T4535 |
Disposable liner/shield/pad |
20,221 |
20,176 |
$526K |
| B4150 |
Ef complet w/intact nutrient |
3,149 |
3,145 |
$291K |
| T4537 |
Reusable underpad bed size |
6,128 |
6,114 |
$233K |
| B4154 |
Ef spec metabolic noninherit |
1,385 |
1,385 |
$197K |
| T4521 |
Adult size brief/diaper sm |
3,218 |
3,215 |
$164K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,783 |
1,650 |
$143K |
| E0240 |
Bath/shower chair |
2,301 |
2,299 |
$84K |
| A4253 |
Blood glucose/reagent strips |
2,312 |
2,305 |
$61K |
| E0990 |
Wheelchair elevating leg res |
1,825 |
1,815 |
$48K |
| A4402 |
Lubricant per ounce |
6,008 |
5,997 |
$41K |
| K0001 |
Standard wheelchair |
1,597 |
1,595 |
$39K |
| A4335 |
Incontinence supply |
319 |
318 |
$36K |
| A4670 |
Automatic bp monitor, dial |
627 |
627 |
$35K |
| E0241 |
Bath tub wall rail |
785 |
782 |
$29K |
| B4152 |
Ef calorie dense>/=1.5kcal |
264 |
264 |
$28K |
| A4259 |
Lancets per box |
1,989 |
1,983 |
$17K |
| E0143 |
Walker folding wheeled w/o s |
160 |
160 |
$14K |
| T4539 |
Reuse diaper/brief any size |
394 |
392 |
$12K |
| E0244 |
Toilet seat raised |
365 |
365 |
$7K |
| E0247 |
Trans bench w/wo comm open |
70 |
70 |
$6K |
| B9998 |
Enteral supp not otherwise c |
19 |
19 |
$4K |
| E0156 |
Walker seat attachment |
169 |
169 |
$4K |
| A4245 |
Alcohol wipes per box |
1,609 |
1,604 |
$4K |
| A4649 |
Surgical supplies |
101 |
101 |
$2K |
| B4100 |
Food thickener oral |
25 |
25 |
$543.87 |
| A4927 |
Non-sterile gloves |
99 |
99 |
$494.31 |