| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4543 |
Adult disp brief/diap abv xl |
2,150 |
2,040 |
$461K |
| T4527 |
Adult size pull-on lg |
4,519 |
4,131 |
$423K |
| B4150 |
Ef complet w/intact nutrient |
4,152 |
3,754 |
$329K |
| T4528 |
Adult size pull-on xl |
3,211 |
2,952 |
$321K |
| T4542 |
Small disposable underpad |
9,593 |
8,803 |
$318K |
| T4526 |
Adult size pull-on med |
3,327 |
3,018 |
$282K |
| T4535 |
Disposable liner/shield/pad |
6,014 |
5,624 |
$273K |
| T1999 |
Noc retail items andsupplies |
5,037 |
4,772 |
$201K |
| T2029 |
Special med equip, noswaiver |
574 |
554 |
$168K |
| A4927 |
Non-sterile gloves |
8,245 |
7,614 |
$114K |
| B4152 |
Ef calorie dense>/=1.5kcal |
788 |
743 |
$81K |
| E0570 |
Nebulizer with compression |
2,009 |
1,878 |
$66K |
| B4154 |
Ef spec metabolic noninherit |
481 |
455 |
$66K |
| T4523 |
Adult size brief/diaper lg |
597 |
544 |
$54K |
| A4670 |
Automatic bp monitor, dial |
1,108 |
1,065 |
$41K |
| K0001 |
Standard wheelchair |
1,246 |
1,177 |
$35K |
| T4524 |
Adult size brief/diaper xl |
231 |
200 |
$23K |
| T4522 |
Adult size brief/diaper med |
109 |
99 |
$9K |
| T4525 |
Adult size pull-on sm |
72 |
67 |
$5K |
| E0143 |
Walker folding wheeled w/o s |
175 |
168 |
$5K |
| E0245 |
Tub stool or bench |
128 |
123 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
28 |
26 |
$2K |
| T4541 |
Large disposable underpad |
48 |
44 |
$2K |
| A7003 |
Nebulizer administration set |
418 |
402 |
$1K |
| T4521 |
Adult size brief/diaper sm |
14 |
14 |
$952.38 |
| E0156 |
Walker seat attachment |
115 |
110 |
$865.83 |
| A4351 |
Straight tip urine catheter |
32 |
25 |
$760.74 |
| T4537 |
Reusable underpad bed size |
12 |
12 |
$690.00 |
| L3908 |
Who cock-up nonmolde pre ots |
19 |
18 |
$595.56 |
| A6402 |
Sterile gauze <= 16 sq in |
20 |
12 |
$130.21 |