| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult size pull-on xl |
6,123 |
5,399 |
$527K |
| T4527 |
Adult size pull-on lg |
7,966 |
7,043 |
$516K |
| A4520 |
Incontinence garment anytype |
6,466 |
4,977 |
$491K |
| T4526 |
Adult size pull-on med |
6,620 |
5,963 |
$418K |
| T4544 |
Adlt disp und/pull on abv xl |
2,753 |
2,373 |
$259K |
| T4535 |
Disposable liner/shield/pad |
4,238 |
3,627 |
$168K |
| T4543 |
Adult disp brief/diap abv xl |
643 |
612 |
$164K |
| T4523 |
Adult size brief/diaper lg |
1,398 |
1,250 |
$115K |
| T4537 |
Reusable underpad bed size |
1,040 |
951 |
$87K |
| T4524 |
Adult size brief/diaper xl |
800 |
768 |
$76K |
| T4525 |
Adult size pull-on sm |
887 |
811 |
$63K |
| T4522 |
Adult size brief/diaper med |
939 |
823 |
$55K |
| T4541 |
Large disposable underpad |
970 |
778 |
$26K |
| E1399 |
Durable medical equipment mi |
229 |
172 |
$22K |
| A4927 |
Non-sterile gloves |
850 |
714 |
$18K |
| E0240 |
Bath/shower chair |
162 |
131 |
$15K |
| A4253 |
Blood glucose/reagent strips |
175 |
157 |
$14K |
| T1999 |
Noc retail items andsupplies |
55 |
46 |
$9K |
| A4554 |
Disposable underpads |
169 |
152 |
$9K |
| E0243 |
Toilet rail |
141 |
90 |
$3K |
| E0244 |
Toilet seat raised |
128 |
84 |
$3K |
| A4259 |
Lancets per box |
168 |
156 |
$2K |