| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
2,006 |
1,778 |
$85K |
| T4526 |
Adult size pull-on med |
433 |
410 |
$39K |
| A6530 |
Compression stocking bk18-30 |
658 |
600 |
$33K |
| T4527 |
Adult size pull-on lg |
304 |
285 |
$31K |
| T4535 |
Disposable liner/shield/pad |
625 |
583 |
$27K |
| A4670 |
Automatic bp monitor, dial |
589 |
518 |
$26K |
| A4927 |
Non-sterile gloves |
947 |
889 |
$20K |
| T4523 |
Adult size brief/diaper lg |
52 |
51 |
$6K |
| T4528 |
Adult size pull-on xl |
37 |
36 |
$3K |
| E0570 |
Nebulizer with compression |
64 |
57 |
$3K |
| E1031 |
Rollabout chair with casters |
32 |
28 |
$1K |
| E0148 |
Heavyduty walker no wheels |
47 |
41 |
$926.40 |