| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
2,674 |
2,641 |
$143K |
| T4535 |
Disposable liner/shield/pad |
2,145 |
2,126 |
$103K |
| T4527 |
Adult size pull-on lg |
831 |
819 |
$55K |
| T4526 |
Adult size pull-on med |
868 |
854 |
$40K |
| A6250 |
Skin seal protect moisturizr |
1,924 |
1,895 |
$28K |
| A4335 |
Incontinence supply |
1,982 |
1,957 |
$12K |
| T4536 |
Reusable pull-on any size |
200 |
200 |
$2K |
| E0570 |
Nebulizer with compression |
148 |
146 |
$1K |
| T4537 |
Reusable underpad bed size |
44 |
43 |
$1K |
| A5120 |
Skin barrier, wipe or swab |
40 |
40 |
$663.07 |
| A4927 |
Non-sterile gloves |
40 |
39 |
$650.64 |
| T4528 |
Adult size pull-on xl |
12 |
12 |
$593.07 |
| T4542 |
Small disposable underpad |
12 |
12 |
$411.41 |