| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
15,019 |
14,552 |
$936K |
| T4527 |
Adult size pull-on lg |
5,290 |
5,120 |
$863K |
| T4541 |
Large disposable underpad |
16,993 |
16,495 |
$840K |
| T4543 |
Adult disp brief/diap abv xl |
2,395 |
2,329 |
$739K |
| T4528 |
Adult size pull-on xl |
3,790 |
3,703 |
$627K |
| T4526 |
Adult size pull-on med |
3,495 |
3,400 |
$570K |
| A4927 |
Non-sterile gloves |
16,989 |
16,506 |
$499K |
| A5120 |
Skin barrier, wipe or swab |
1,655 |
1,630 |
$90K |
| T4523 |
Adult size brief/diaper lg |
465 |
444 |
$64K |
| A6250 |
Skin seal protect moisturizr |
10,349 |
9,938 |
$24K |
| A6533 |
Gc stocking thighlngth 18-30 |
55 |
53 |
$21K |
| A6534 |
Gc stocking thighlngth 30-40 |
32 |
31 |
$14K |
| T4524 |
Adult size brief/diaper xl |
75 |
74 |
$13K |
| A5500 |
Diab shoe for density insert |
340 |
161 |
$12K |
| T4537 |
Reusable underpad bed size |
1,537 |
1,196 |
$12K |
| A4553 |
Nondisp underpads, all sizes |
801 |
791 |
$12K |
| A6530 |
Compression stocking bk18-30 |
48 |
43 |
$11K |
| K0003 |
Lightweight wheelchair |
62 |
61 |
$3K |
| A5514 |
Mult den insert dir carv/cam |
328 |
157 |
$2K |
| K0004 |
High strength ltwt whlchr |
156 |
153 |
$1K |