| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
12,055 |
11,457 |
$776K |
| T4526 |
Adult size pull-on med |
5,031 |
4,782 |
$633K |
| T4527 |
Adult size pull-on lg |
5,145 |
4,897 |
$616K |
| T4535 |
Disposable liner/shield/pad |
12,999 |
12,420 |
$592K |
| T4528 |
Adult size pull-on xl |
2,290 |
2,186 |
$365K |
| A4670 |
Automatic bp monitor, dial |
4,151 |
3,917 |
$250K |
| T4530 |
Ped size brief/diaper lg |
1,962 |
1,819 |
$230K |
| A4927 |
Non-sterile gloves |
13,702 |
12,897 |
$182K |
| A6530 |
Compression stocking bk18-30 |
2,182 |
2,042 |
$133K |
| T4525 |
Adult size pull-on sm |
1,224 |
1,180 |
$127K |
| E0240 |
Bath/shower chair |
928 |
875 |
$94K |
| E0143 |
Walker folding wheeled w/o s |
811 |
718 |
$56K |
| A5500 |
Diab shoe for density insert |
753 |
541 |
$48K |
| T4531 |
Ped size pull-on sm/med |
441 |
358 |
$45K |
| T4522 |
Adult size brief/diaper med |
358 |
323 |
$38K |
| K0001 |
Standard wheelchair |
385 |
362 |
$13K |
| E0603 |
Electric breast pump |
122 |
121 |
$13K |
| E0156 |
Walker seat attachment |
672 |
596 |
$9K |
| E0445 |
Oximeter non-invasive |
208 |
179 |
$9K |
| A5512 |
Multi den insert direct form |
103 |
93 |
$5K |
| L3908 |
Who cock-up nonmolde pre ots |
132 |
107 |
$4K |
| T4544 |
Adlt disp und/pull on abv xl |
13 |
13 |
$3K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
13 |
13 |
$3K |
| E0243 |
Toilet rail |
42 |
42 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
54 |
53 |
$849.20 |
| E0244 |
Toilet seat raised |
39 |
39 |
$794.39 |
| E0241 |
Bath tub wall rail |
31 |
30 |
$788.03 |
| E0105 |
Cane adjust/fixed quad/3 pro |
31 |
24 |
$756.71 |