| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
12,828 |
12,516 |
$456K |
| T4526 |
Adult size pull-on med |
5,033 |
4,909 |
$391K |
| T4527 |
Adult size pull-on lg |
4,341 |
4,245 |
$335K |
| T4528 |
Adult size pull-on xl |
3,506 |
3,438 |
$330K |
| T4523 |
Adult size brief/diaper lg |
3,329 |
3,266 |
$275K |
| T4524 |
Adult size brief/diaper xl |
2,793 |
2,747 |
$247K |
| T4522 |
Adult size brief/diaper med |
3,632 |
3,559 |
$236K |
| T4544 |
Adlt disp und/pull on abv xl |
1,237 |
1,205 |
$163K |
| T4535 |
Disposable liner/shield/pad |
5,053 |
4,916 |
$127K |
| A5120 |
Skin barrier, wipe or swab |
4,901 |
4,771 |
$57K |
| E2361 |
22nf sealed leadacid battery |
180 |
163 |
$38K |
| E2386 |
Foam filled drive wheel tire |
140 |
126 |
$28K |
| E2366 |
Battery charger, single mode |
163 |
145 |
$26K |
| E2387 |
Foam filled caster tire |
102 |
93 |
$17K |
| E0245 |
Tub stool or bench |
118 |
109 |
$8K |
| A4670 |
Automatic bp monitor, dial |
60 |
60 |
$3K |
| A4612 |
Battery cables |
33 |
29 |
$2K |