| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4155 |
Ef incomplete/modular |
6,869 |
5,917 |
$3.88M |
| A5120 |
Skin barrier, wipe or swab |
89,472 |
23,221 |
$2.39M |
| B4154 |
Ef spec metabolic noninherit |
2,965 |
2,685 |
$978K |
| A4554 |
Disposable underpads |
14,807 |
14,252 |
$941K |
| T4535 |
Disposable liner/shield/pad |
12,616 |
12,007 |
$903K |
| A4927 |
Non-sterile gloves |
24,593 |
21,757 |
$725K |
| T4527 |
Adult size pull-on lg |
4,093 |
3,901 |
$661K |
| T4526 |
Adult size pull-on med |
4,626 |
4,389 |
$594K |
| A6530 |
Compression stocking bk18-30 |
5,663 |
5,489 |
$400K |
| T4528 |
Adult size pull-on xl |
2,265 |
2,124 |
$360K |
| A6250 |
Skin seal protect moisturizr |
22,295 |
19,710 |
$305K |
| T4525 |
Adult size pull-on sm |
1,689 |
1,618 |
$168K |
| B4152 |
Ef calorie dense>/=1.5kcal |
573 |
554 |
$109K |
| T4544 |
Adlt disp und/pull on abv xl |
293 |
284 |
$70K |
| A4670 |
Automatic bp monitor, dial |
108 |
102 |
$7K |
| E0242 |
Bath tub rail floor |
84 |
63 |
$7K |
| K0001 |
Standard wheelchair |
639 |
472 |
$5K |
| T4523 |
Adult size brief/diaper lg |
24 |
24 |
$3K |
| A6533 |
Gc stocking thighlngth 18-30 |
25 |
24 |
$2K |
| E0245 |
Tub stool or bench |
48 |
40 |
$2K |
| T4522 |
Adult size brief/diaper med |
14 |
14 |
$2K |
| E0570 |
Nebulizer with compression |
83 |
58 |
$1K |
| E0100 |
Cane adjust/fixed with tip |
50 |
41 |
$836.96 |
| K0195 |
Elevating whlchair leg rests |
73 |
60 |
$155.17 |