| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
8,549 |
5,893 |
$1.07M |
| S5165 |
Home modifications per serv |
2,059 |
1,706 |
$699K |
| T4535 |
Disposable liner/shield/pad |
6,109 |
5,934 |
$478K |
| T4527 |
Adult size pull-on lg |
3,982 |
3,903 |
$454K |
| E1399 |
Durable medical equipment mi |
3,905 |
2,585 |
$424K |
| T4526 |
Adult size pull-on med |
4,016 |
3,934 |
$404K |
| T4541 |
Large disposable underpad |
6,201 |
6,033 |
$308K |
| T4528 |
Adult size pull-on xl |
2,386 |
2,325 |
$304K |
| T4523 |
Adult size brief/diaper lg |
598 |
577 |
$111K |
| T4543 |
Adult disp brief/diap abv xl |
359 |
345 |
$101K |
| T4534 |
Youth size pull-on |
660 |
641 |
$86K |
| A6532 |
Compress stking bk40-50 surg |
304 |
296 |
$78K |
| A4927 |
Non-sterile gloves |
1,829 |
1,795 |
$52K |
| B4150 |
Ef complet w/intact nutrient |
475 |
455 |
$52K |
| T4525 |
Adult size pull-on sm |
49 |
48 |
$5K |
| T4522 |
Adult size brief/diaper med |
12 |
12 |
$2K |
| A9270 |
Non-covered item or service |
214 |
175 |
$0.00 |