| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
16,739 |
16,586 |
$1.90M |
| T4535 |
Disposable liner/shield/pad |
31,466 |
31,108 |
$1.66M |
| T4526 |
Adult size pull-on med |
12,015 |
11,890 |
$1.31M |
| A4927 |
Non-sterile gloves |
40,561 |
40,090 |
$684K |
| T4541 |
Large disposable underpad |
16,459 |
16,264 |
$644K |
| T4528 |
Adult size pull-on xl |
4,235 |
4,189 |
$464K |
| T4542 |
Small disposable underpad |
5,442 |
5,390 |
$195K |
| T4523 |
Adult size brief/diaper lg |
1,767 |
1,744 |
$172K |
| T4525 |
Adult size pull-on sm |
1,431 |
1,411 |
$159K |
| T4524 |
Adult size brief/diaper xl |
1,302 |
1,275 |
$154K |
| A4553 |
Nondisp underpads, all sizes |
6,738 |
6,658 |
$102K |
| A6250 |
Skin seal protect moisturizr |
1,148 |
1,137 |
$72K |
| A4245 |
Alcohol wipes per box |
8,205 |
8,101 |
$67K |
| A6530 |
Compression stocking bk18-30 |
259 |
256 |
$31K |
| A4259 |
Lancets per box |
8,008 |
7,657 |
$29K |
| T4537 |
Reusable underpad bed size |
626 |
615 |
$10K |
| A4253 |
Blood glucose/reagent strips |
8,312 |
7,944 |
$7K |
| T4522 |
Adult size brief/diaper med |
67 |
67 |
$5K |
| A4670 |
Automatic bp monitor, dial |
82 |
78 |
$4K |
| K0001 |
Standard wheelchair |
101 |
76 |
$400.67 |
| L1810 |
Ko elastic with joints |
15 |
15 |
$292.32 |
| E0156 |
Walker seat attachment |
17 |
17 |
$259.88 |
| E0143 |
Walker folding wheeled w/o s |
29 |
29 |
$162.54 |
| E0607 |
Blood glucose monitor home |
14 |
14 |
$30.40 |
| A4335 |
Incontinence supply |
22 |
22 |
$0.00 |