| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
6,738 |
6,642 |
$644K |
| T4526 |
Adult size pull-on med |
5,863 |
5,775 |
$457K |
| T4541 |
Large disposable underpad |
9,616 |
9,496 |
$395K |
| A4927 |
Non-sterile gloves |
24,149 |
23,915 |
$394K |
| T4537 |
Reusable underpad bed size |
7,523 |
7,445 |
$361K |
| T4528 |
Adult size pull-on xl |
3,741 |
3,683 |
$358K |
| T4535 |
Disposable liner/shield/pad |
8,005 |
7,374 |
$324K |
| T4544 |
Adlt disp und/pull on abv xl |
2,039 |
1,989 |
$289K |
| A4335 |
Incontinence supply |
7,964 |
7,814 |
$229K |
| T4525 |
Adult size pull-on sm |
1,351 |
1,328 |
$104K |
| T4523 |
Adult size brief/diaper lg |
1,172 |
1,154 |
$94K |
| S9999 |
Sales tax |
5,955 |
5,667 |
$69K |
| K0001 |
Standard wheelchair |
1,707 |
1,678 |
$29K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,486 |
1,475 |
$28K |
| T4534 |
Youth size pull-on |
251 |
239 |
$21K |
| T4522 |
Adult size brief/diaper med |
161 |
157 |
$11K |
| E0627 |
Seat lift mech, electric any |
15 |
15 |
$5K |
| E0143 |
Walker folding wheeled w/o s |
101 |
99 |
$3K |
| A4351 |
Straight tip urine catheter |
26 |
24 |
$3K |
| E0272 |
Mattress foam rubber |
351 |
348 |
$3K |
| E0271 |
Mattress innerspring |
517 |
506 |
$3K |
| L3908 |
Who cock-up nonmolde pre ots |
33 |
24 |
$1K |
| T4524 |
Adult size brief/diaper xl |
12 |
12 |
$1K |
| K0006 |
Heavy duty wheelchair |
12 |
12 |
$530.46 |
| A4357 |
Bedside drainage bag |
38 |
36 |
$333.25 |
| E0156 |
Walker seat attachment |
13 |
13 |
$117.80 |
| E0181 |
Press pad alternating w/ pum |
12 |
12 |
$111.10 |