| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
13,380 |
11,116 |
$2.87M |
| T4526 |
Adult size pull-on med |
2,342 |
2,079 |
$198K |
| T4528 |
Adult size pull-on xl |
1,725 |
1,493 |
$175K |
| T4541 |
Large disposable underpad |
4,559 |
4,025 |
$162K |
| T4527 |
Adult size pull-on lg |
1,658 |
1,370 |
$156K |
| T4535 |
Disposable liner/shield/pad |
3,129 |
2,571 |
$119K |
| S5165 |
Home modifications per serv |
612 |
583 |
$98K |
| T4537 |
Reusable underpad bed size |
962 |
836 |
$89K |
| A4927 |
Non-sterile gloves |
6,325 |
5,374 |
$87K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,740 |
1,597 |
$53K |
| T4543 |
Adult disp brief/diap abv xl |
80 |
65 |
$20K |
| E0627 |
Seat lift mech, electric any |
273 |
245 |
$13K |
| E0245 |
Tub stool or bench |
395 |
366 |
$12K |
| K0001 |
Standard wheelchair |
419 |
361 |
$10K |
| T1999 |
Noc retail items andsupplies |
37 |
27 |
$4K |
| E0241 |
Bath tub wall rail |
176 |
163 |
$3K |
| E0247 |
Trans bench w/wo comm open |
39 |
38 |
$2K |
| T4525 |
Adult size pull-on sm |
17 |
15 |
$1K |
| E0244 |
Toilet seat raised |
43 |
37 |
$1K |