| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5165 |
Home modifications per serv |
537 |
517 |
$2.03M |
| A4554 |
Disposable underpads |
24,530 |
24,184 |
$899K |
| T4528 |
Adult size pull-on xl |
5,208 |
5,107 |
$800K |
| T4527 |
Adult size pull-on lg |
6,029 |
5,956 |
$748K |
| T4535 |
Disposable liner/shield/pad |
16,777 |
16,396 |
$711K |
| T4526 |
Adult size pull-on med |
5,078 |
5,002 |
$508K |
| B4150 |
Ef complet w/intact nutrient |
3,747 |
2,524 |
$292K |
| B4154 |
Ef spec metabolic noninherit |
1,525 |
1,036 |
$285K |
| E1399 |
Durable medical equipment mi |
339 |
263 |
$200K |
| A4335 |
Incontinence supply |
27,786 |
27,257 |
$151K |
| T4525 |
Adult size pull-on sm |
846 |
829 |
$71K |
| A6250 |
Skin seal protect moisturizr |
12,893 |
12,671 |
$64K |
| T4524 |
Adult size brief/diaper xl |
298 |
288 |
$37K |
| E0260 |
Hosp bed semi-electr w/ matt |
770 |
750 |
$37K |
| T4534 |
Youth size pull-on |
264 |
241 |
$31K |
| K0003 |
Lightweight wheelchair |
1,876 |
1,836 |
$28K |
| T4523 |
Adult size brief/diaper lg |
208 |
205 |
$22K |
| E0240 |
Bath/shower chair |
124 |
121 |
$22K |
| A4670 |
Automatic bp monitor, dial |
115 |
111 |
$6K |
| K0195 |
Elevating whlchair leg rests |
1,009 |
976 |
$3K |
| E0630 |
Patient lift hydraulic |
27 |
26 |
$518.91 |
| E0143 |
Walker folding wheeled w/o s |
14 |
12 |
$512.47 |
| E0570 |
Nebulizer with compression |
218 |
214 |
$225.85 |