| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9977 |
Meals per diem |
3,119 |
2,938 |
$448K |
| T4526 |
Adult size pull-on med |
4,090 |
3,647 |
$447K |
| E1390 |
Oxygen concentrator |
3,770 |
3,439 |
$312K |
| T4535 |
Disposable liner/shield/pad |
2,509 |
2,216 |
$195K |
| A4335 |
Incontinence supply |
6,629 |
5,945 |
$166K |
| T4541 |
Large disposable underpad |
3,324 |
2,884 |
$98K |
| T2028 |
Special supply, nos waiver |
700 |
635 |
$86K |
| E1392 |
Portable oxygen concentrator |
2,453 |
2,218 |
$62K |
| A4927 |
Non-sterile gloves |
2,745 |
2,455 |
$47K |
| T4527 |
Adult size pull-on lg |
396 |
352 |
$42K |
| T2029 |
Special med equip, noswaiver |
169 |
161 |
$22K |
| K0001 |
Standard wheelchair |
853 |
660 |
$21K |
| E0570 |
Nebulizer with compression |
294 |
192 |
$18K |
| T4528 |
Adult size pull-on xl |
122 |
108 |
$14K |
| K0738 |
Portable gas oxygen system |
159 |
149 |
$10K |
| A7005 |
Nondisposable nebulizer set |
295 |
195 |
$5K |
| T4544 |
Adlt disp und/pull on abv xl |
46 |
39 |
$4K |