| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
41,009 |
32,732 |
$2.83M |
| T4526 |
Adult size pull-on med |
45,413 |
36,313 |
$2.59M |
| A4927 |
Non-sterile gloves |
156,657 |
125,990 |
$2.51M |
| T4541 |
Large disposable underpad |
66,959 |
53,673 |
$2.27M |
| T4535 |
Disposable liner/shield/pad |
73,582 |
58,489 |
$2.21M |
| T4537 |
Reusable underpad bed size |
33,351 |
27,422 |
$1.24M |
| T4528 |
Adult size pull-on xl |
18,057 |
14,468 |
$1.22M |
| A4335 |
Incontinence supply |
28,552 |
23,039 |
$668K |
| T4523 |
Adult size brief/diaper lg |
9,010 |
7,171 |
$661K |
| T4544 |
Adlt disp und/pull on abv xl |
4,893 |
3,707 |
$573K |
| T4525 |
Adult size pull-on sm |
7,262 |
5,979 |
$429K |
| T4524 |
Adult size brief/diaper xl |
5,220 |
3,966 |
$427K |
| T4522 |
Adult size brief/diaper med |
6,501 |
5,068 |
$356K |
| T4543 |
Adult disp brief/diap abv xl |
1,750 |
1,242 |
$323K |
| E0240 |
Bath/shower chair |
1,542 |
1,479 |
$163K |
| E1399 |
Durable medical equipment mi |
1,325 |
1,160 |
$42K |
| E0247 |
Trans bench w/wo comm open |
254 |
240 |
$41K |
| S9999 |
Sales tax |
8,072 |
6,115 |
$37K |
| E0244 |
Toilet seat raised |
416 |
398 |
$31K |
| E0241 |
Bath tub wall rail |
249 |
230 |
$11K |
| E0163 |
Commode chair with fixed arm |
170 |
164 |
$11K |
| A4349 |
Disposable male external cat |
16 |
13 |
$633.70 |
| A4358 |
Urinary leg or abdomen bag |
138 |
128 |
$497.47 |
| A4357 |
Bedside drainage bag |
62 |
61 |
$426.29 |
| A9270 |
Non-covered item or service |
19 |
15 |
$0.00 |