| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
34,989 |
34,662 |
$1.92M |
| T4535 |
Disposable liner/shield/pad |
25,814 |
25,564 |
$1.32M |
| T4526 |
Adult size pull-on med |
20,756 |
20,566 |
$943K |
| T4523 |
Adult size brief/diaper lg |
3,824 |
3,809 |
$259K |
| T4527 |
Adult size pull-on lg |
3,497 |
3,478 |
$227K |
| T4536 |
Reusable pull-on any size |
14,908 |
14,815 |
$181K |
| T4522 |
Adult size brief/diaper med |
1,050 |
1,050 |
$66K |
| A6250 |
Skin seal protect moisturizr |
3,023 |
3,016 |
$47K |
| A5500 |
Diab shoe for density insert |
716 |
414 |
$30K |
| A4253 |
Blood glucose/reagent strips |
1,608 |
1,476 |
$14K |
| T4537 |
Reusable underpad bed size |
385 |
384 |
$11K |
| A5512 |
Multi den insert direct form |
695 |
397 |
$6K |
| K0003 |
Lightweight wheelchair |
257 |
257 |
$3K |
| T4525 |
Adult size pull-on sm |
26 |
26 |
$1K |
| A4259 |
Lancets per box |
1,603 |
1,471 |
$1K |
| A4335 |
Incontinence supply |
49 |
48 |
$378.42 |