| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
16,785 |
16,411 |
$838K |
| T4526 |
Adult size pull-on med |
3,347 |
3,267 |
$229K |
| T4527 |
Adult size pull-on lg |
2,814 |
2,782 |
$214K |
| T4541 |
Large disposable underpad |
4,425 |
4,326 |
$190K |
| T2029 |
Special med equip, noswaiver |
10,934 |
8,971 |
$188K |
| T4528 |
Adult size pull-on xl |
1,821 |
1,785 |
$165K |
| A5120 |
Skin barrier, wipe or swab |
2,290 |
2,172 |
$75K |
| A6530 |
Compression stocking bk18-30 |
1,042 |
1,025 |
$52K |
| A5500 |
Diab shoe for density insert |
367 |
264 |
$25K |
| A4927 |
Non-sterile gloves |
1,829 |
1,810 |
$22K |
| A5512 |
Multi den insert direct form |
261 |
246 |
$20K |
| A4253 |
Blood glucose/reagent strips |
27 |
24 |
$13.31 |
| T4536 |
Reusable pull-on any size |
482 |
475 |
$0.00 |