| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
4,100 |
3,987 |
$753K |
| A6250 |
Skin seal protect moisturizr |
9,245 |
8,678 |
$753K |
| A4554 |
Disposable underpads |
8,123 |
7,926 |
$466K |
| T4535 |
Disposable liner/shield/pad |
4,935 |
4,827 |
$269K |
| A4927 |
Non-sterile gloves |
9,386 |
8,888 |
$221K |
| E0221 |
Infrared heating pad system |
100 |
58 |
$219K |
| T4526 |
Adult size pull-on med |
1,646 |
1,590 |
$197K |
| B4154 |
Ef spec metabolic noninherit |
497 |
470 |
$139K |
| T4534 |
Youth size pull-on |
578 |
570 |
$106K |
| T4528 |
Adult size pull-on xl |
359 |
348 |
$55K |
| B4150 |
Ef complet w/intact nutrient |
525 |
500 |
$52K |
| E1399 |
Durable medical equipment mi |
257 |
240 |
$42K |
| B4152 |
Ef calorie dense>/=1.5kcal |
96 |
92 |
$19K |
| E0570 |
Nebulizer with compression |
338 |
335 |
$16K |
| A4252 |
Blood ketone test or strip |
24 |
24 |
$11K |
| E0135 |
Walker folding adjust/fixed |
243 |
226 |
$10K |
| A4627 |
Spacer bag/reservoir |
309 |
308 |
$8K |
| E0245 |
Tub stool or bench |
143 |
137 |
$7K |
| T4522 |
Adult size brief/diaper med |
13 |
12 |
$2K |
| A4253 |
Blood glucose/reagent strips |
239 |
226 |
$2K |
| A6530 |
Compression stocking bk18-30 |
34 |
34 |
$1K |
| A6533 |
Gc stocking thighlngth 18-30 |
29 |
29 |
$1K |
| A4259 |
Lancets per box |
254 |
241 |
$919.79 |
| A4245 |
Alcohol wipes per box |
131 |
128 |
$610.00 |