| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5165 |
Home modifications; per service |
971 |
890 |
$318K |
| A4554 |
Disposable underpads, all sizes |
7,770 |
7,553 |
$250K |
| X1939 |
|
3,149 |
3,133 |
$217K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,054 |
2,019 |
$135K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,181 |
2,121 |
$111K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
741 |
727 |
$98K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,676 |
1,624 |
$75K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,294 |
2,237 |
$66K |
| T5999 |
Supply, not otherwise specified |
10,772 |
10,641 |
$60K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
1,052 |
1,052 |
$32K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
50 |
50 |
$6K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
55 |
52 |
$5K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
24 |
24 |
$2K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
12 |
12 |
$891.00 |