| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
54,317 |
53,310 |
$2.69M |
| T4527 |
Adult size pull-on lg |
24,794 |
24,398 |
$2.21M |
| T4528 |
Adult size pull-on xl |
15,850 |
15,597 |
$1.71M |
| T4526 |
Adult size pull-on med |
20,455 |
20,181 |
$1.63M |
| T4541 |
Large disposable underpad |
42,633 |
41,620 |
$1.43M |
| T4543 |
Adult disp brief/diap abv xl |
4,672 |
4,587 |
$760K |
| T1999 |
Noc retail items andsupplies |
3,524 |
3,407 |
$592K |
| T4537 |
Reusable underpad bed size |
4,365 |
4,342 |
$475K |
| T4544 |
Adlt disp und/pull on abv xl |
2,026 |
2,017 |
$333K |
| B4150 |
Ef complet w/intact nutrient |
2,822 |
2,787 |
$307K |
| T4525 |
Adult size pull-on sm |
4,299 |
4,251 |
$261K |
| T4523 |
Adult size brief/diaper lg |
1,705 |
1,664 |
$173K |
| T4524 |
Adult size brief/diaper xl |
1,428 |
1,409 |
$169K |
| S5165 |
Home modifications per serv |
1,077 |
1,074 |
$169K |
| B4154 |
Ef spec metabolic noninherit |
719 |
715 |
$140K |
| B4152 |
Ef calorie dense>/=1.5kcal |
708 |
702 |
$117K |
| E1399 |
Durable medical equipment mi |
2,073 |
1,990 |
$108K |
| A4927 |
Non-sterile gloves |
4,449 |
4,409 |
$72K |
| E0240 |
Bath/shower chair |
883 |
883 |
$69K |
| T4542 |
Small disposable underpad |
2,757 |
2,685 |
$52K |
| E0241 |
Bath tub wall rail |
322 |
312 |
$45K |
| E0244 |
Toilet seat raised |
406 |
406 |
$30K |
| E0247 |
Trans bench w/wo comm open |
166 |
166 |
$24K |
| E0246 |
Transfer tub rail attachment |
216 |
216 |
$13K |
| T4522 |
Adult size brief/diaper med |
36 |
36 |
$3K |
| T4540 |
Reusable underpad chair size |
27 |
27 |
$3K |
| A9281 |
Reaching/grabbing device |
36 |
36 |
$1K |