| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4543 |
Adult disp brief/diap abv xl |
3,464 |
3,185 |
$1.39M |
| T4527 |
Adult size pull-on lg |
5,598 |
5,358 |
$786K |
| E1399 |
Durable medical equipment mi |
4,068 |
3,492 |
$786K |
| T4524 |
Adult size brief/diaper xl |
3,561 |
3,423 |
$642K |
| T4526 |
Adult size pull-on med |
5,509 |
5,268 |
$639K |
| T4534 |
Youth size pull-on |
4,579 |
4,031 |
$561K |
| T4522 |
Adult size brief/diaper med |
3,132 |
2,938 |
$486K |
| T4533 |
Youth size brief/diaper |
3,965 |
2,843 |
$457K |
| T4523 |
Adult size brief/diaper lg |
2,732 |
2,636 |
$432K |
| T2029 |
Special med equip, noswaiver |
4,000 |
2,809 |
$391K |
| T4535 |
Disposable liner/shield/pad |
6,615 |
6,265 |
$149K |
| A4649 |
Surgical supplies |
13,448 |
12,740 |
$138K |
| T4528 |
Adult size pull-on xl |
953 |
918 |
$137K |
| E0445 |
Oximeter non-invasive |
938 |
457 |
$123K |
| B4100 |
Food thickener oral |
461 |
449 |
$103K |
| A4927 |
Non-sterile gloves |
19,738 |
18,458 |
$93K |
| T4525 |
Adult size pull-on sm |
806 |
749 |
$87K |
| A4554 |
Disposable underpads |
12,931 |
12,122 |
$83K |
| B4154 |
Ef spec metabolic noninherit |
97 |
86 |
$18K |
| B4088 |
Gastro/jejuno tube, low-pro |
316 |
102 |
$9K |
| B4035 |
Enteral feed supp pump per d |
15 |
12 |
$3K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
29 |
27 |
$2K |
| A4670 |
Automatic bp monitor, dial |
72 |
44 |
$1K |