| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
11,121 |
10,567 |
$1.03M |
| T4527 |
Adult size pull-on lg |
8,339 |
8,096 |
$912K |
| T4528 |
Adult size pull-on xl |
5,967 |
5,692 |
$819K |
| T4534 |
Youth size pull-on |
6,574 |
6,145 |
$806K |
| T2029 |
Special med equip, noswaiver |
7,070 |
6,073 |
$755K |
| T4526 |
Adult size pull-on med |
6,432 |
6,245 |
$666K |
| E1399 |
Durable medical equipment mi |
4,273 |
3,971 |
$592K |
| T4541 |
Large disposable underpad |
9,512 |
9,265 |
$459K |
| T4522 |
Adult size brief/diaper med |
2,716 |
2,681 |
$387K |
| T4523 |
Adult size brief/diaper lg |
1,620 |
1,593 |
$257K |
| T4544 |
Adlt disp und/pull on abv xl |
819 |
768 |
$181K |
| T4525 |
Adult size pull-on sm |
1,214 |
1,170 |
$136K |
| T4533 |
Youth size brief/diaper |
986 |
967 |
$136K |
| T4530 |
Ped size brief/diaper lg |
808 |
793 |
$121K |
| T4532 |
Ped size pull-on lg |
850 |
792 |
$87K |
| T4521 |
Adult size brief/diaper sm |
594 |
575 |
$83K |
| A4927 |
Non-sterile gloves |
2,704 |
2,665 |
$57K |
| A4351 |
Straight tip urine catheter |
163 |
161 |
$40K |
| T4524 |
Adult size brief/diaper xl |
83 |
79 |
$20K |
| A4402 |
Lubricant per ounce |
36 |
36 |
$395.96 |