| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
42,452 |
41,369 |
$1.96M |
| T4526 |
Adult size pull-on med |
27,024 |
26,290 |
$1.52M |
| T4527 |
Adult size pull-on lg |
13,454 |
13,079 |
$876K |
| T4535 |
Disposable liner/shield/pad |
14,780 |
13,869 |
$734K |
| T4523 |
Adult size brief/diaper lg |
6,027 |
5,830 |
$437K |
| T4522 |
Adult size brief/diaper med |
6,119 |
5,919 |
$347K |
| T4525 |
Adult size pull-on sm |
4,802 |
4,797 |
$252K |
| T4528 |
Adult size pull-on xl |
2,475 |
2,389 |
$160K |
| A6250 |
Skin seal protect moisturizr |
16,083 |
16,048 |
$138K |
| T4524 |
Adult size brief/diaper xl |
1,745 |
1,733 |
$122K |
| A4335 |
Incontinence supply |
15,609 |
15,584 |
$78K |
| E0245 |
Tub stool or bench |
1,160 |
1,152 |
$56K |
| T4537 |
Reusable underpad bed size |
1,824 |
1,799 |
$51K |
| E0143 |
Walker folding wheeled w/o s |
1,181 |
1,181 |
$25K |
| K0001 |
Standard wheelchair |
349 |
349 |
$5K |
| K0002 |
Stnd hemi (low seat) whlchr |
116 |
116 |
$5K |
| E0156 |
Walker seat attachment |
991 |
991 |
$5K |
| E0163 |
Commode chair with fixed arm |
38 |
38 |
$779.34 |
| E0105 |
Cane adjust/fixed quad/3 pro |
51 |
51 |
$341.03 |