| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
36,668 |
36,189 |
$1.98M |
| T4528 |
Adult size pull-on xl |
12,048 |
11,885 |
$1.30M |
| T4527 |
Adult size pull-on lg |
13,090 |
12,921 |
$1.21M |
| T4526 |
Adult size pull-on med |
12,975 |
12,780 |
$1.08M |
| T4541 |
Large disposable underpad |
21,835 |
21,255 |
$786K |
| T4543 |
Adult disp brief/diap abv xl |
4,447 |
4,400 |
$744K |
| T4537 |
Reusable underpad bed size |
3,792 |
3,785 |
$414K |
| T1999 |
Noc retail items andsupplies |
2,070 |
1,997 |
$369K |
| T4544 |
Adlt disp und/pull on abv xl |
1,140 |
1,138 |
$201K |
| T4525 |
Adult size pull-on sm |
2,589 |
2,563 |
$186K |
| T4542 |
Small disposable underpad |
6,940 |
6,813 |
$164K |
| B4150 |
Ef complet w/intact nutrient |
1,067 |
1,056 |
$156K |
| A4927 |
Non-sterile gloves |
4,556 |
4,499 |
$69K |
| E1399 |
Durable medical equipment mi |
1,324 |
1,295 |
$60K |
| B4154 |
Ef spec metabolic noninherit |
183 |
177 |
$48K |
| T4523 |
Adult size brief/diaper lg |
416 |
408 |
$43K |
| E0240 |
Bath/shower chair |
409 |
409 |
$38K |
| T4524 |
Adult size brief/diaper xl |
214 |
212 |
$26K |
| S5165 |
Home modifications per serv |
111 |
110 |
$14K |
| A4335 |
Incontinence supply |
746 |
744 |
$8K |
| E0244 |
Toilet seat raised |
108 |
108 |
$8K |
| B4152 |
Ef calorie dense>/=1.5kcal |
33 |
32 |
$8K |
| E0260 |
Hosp bed semi-electr w/ matt |
196 |
196 |
$6K |
| E0246 |
Transfer tub rail attachment |
52 |
52 |
$4K |
| E0570 |
Nebulizer with compression |
27 |
27 |
$2K |
| K0001 |
Standard wheelchair |
12 |
12 |
$273.32 |