| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
61,546 |
61,448 |
$2.78M |
| T4522 |
Adult size brief/diaper med |
32,862 |
32,806 |
$1.76M |
| T4526 |
Adult size pull-on med |
38,490 |
38,422 |
$1.50M |
| T4535 |
Disposable liner/shield/pad |
24,344 |
24,311 |
$1.06M |
| T4523 |
Adult size brief/diaper lg |
8,263 |
8,252 |
$467K |
| T4527 |
Adult size pull-on lg |
9,527 |
9,518 |
$458K |
| A6250 |
Skin seal protect moisturizr |
15,913 |
15,879 |
$403K |
| T4537 |
Reusable underpad bed size |
4,221 |
4,218 |
$92K |
| T4524 |
Adult size brief/diaper xl |
1,238 |
1,236 |
$66K |
| T4528 |
Adult size pull-on xl |
1,466 |
1,464 |
$62K |
| E0245 |
Tub stool or bench |
768 |
767 |
$33K |
| E0247 |
Trans bench w/wo comm open |
296 |
296 |
$27K |
| K0001 |
Standard wheelchair |
1,031 |
1,030 |
$15K |
| E0241 |
Bath tub wall rail |
102 |
102 |
$4K |
| E0973 |
W/ch access det adj armrest |
859 |
858 |
$2K |
| A4670 |
Automatic bp monitor, dial |
30 |
29 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
889 |
889 |
$2K |
| E0295 |
Hosp bed semi-elect w/o matt |
73 |
73 |
$959.03 |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$719.25 |
| A4335 |
Incontinence supply |
900 |
898 |
$566.20 |
| E0246 |
Transfer tub rail attachment |
12 |
12 |
$459.20 |
| E0951 |
Loop heel |
767 |
766 |
$179.10 |
| E0305 |
Rails bed side half length |
72 |
72 |
$151.58 |
| E0271 |
Mattress innerspring |
25 |
25 |
$101.80 |