| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
266 |
252 |
$10K |
| L3908 |
Who cock-up nonmolde pre ots |
227 |
172 |
$8K |
| T4527 |
Adult size pull-on lg |
101 |
98 |
$8K |
| A6530 |
Compression stocking bk18-30 |
213 |
151 |
$8K |
| T4526 |
Adult size pull-on med |
106 |
98 |
$6K |
| A4670 |
Automatic bp monitor, dial |
125 |
121 |
$5K |
| A4927 |
Non-sterile gloves |
268 |
258 |
$4K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
30 |
30 |
$4K |
| A4351 |
Straight tip urine catheter |
45 |
37 |
$3K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
71 |
60 |
$3K |
| L1820 |
Ko elas w/ condyle pads & jo |
47 |
27 |
$3K |
| T4535 |
Disposable liner/shield/pad |
69 |
60 |
$2K |
| A5063 |
Drain ostomy pouch w/flange |
90 |
71 |
$2K |
| E0570 |
Nebulizer with compression |
23 |
17 |
$1K |
| A4385 |
Ost skn barrier sld ext wear |
72 |
47 |
$1K |
| L0621 |
Sio flex pelvic/sacr pre ots |
12 |
12 |
$564.69 |
| E0100 |
Cane adjust/fixed with tip |
47 |
46 |
$387.35 |
| A4357 |
Bedside drainage bag |
50 |
40 |
$259.62 |