| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
20,131 |
20,001 |
$1.38M |
| T4535 |
Disposable liner/shield/pad |
17,434 |
17,324 |
$1.00M |
| T4527 |
Adult size pull-on lg |
5,484 |
5,466 |
$378K |
| T4526 |
Adult size pull-on med |
6,194 |
6,187 |
$372K |
| T4528 |
Adult size pull-on xl |
2,863 |
2,816 |
$182K |
| T4536 |
Reusable pull-on any size |
14,840 |
14,734 |
$180K |
| T4534 |
Youth size pull-on |
1,357 |
1,354 |
$124K |
| T4525 |
Adult size pull-on sm |
2,214 |
2,171 |
$123K |
| T4537 |
Reusable underpad bed size |
2,604 |
2,575 |
$79K |
| E0570 |
Nebulizer with compression |
593 |
588 |
$55K |
| K0001 |
Standard wheelchair |
439 |
434 |
$26K |
| T4523 |
Adult size brief/diaper lg |
531 |
530 |
$26K |
| T4522 |
Adult size brief/diaper med |
478 |
478 |
$25K |
| E0603 |
Electric breast pump |
272 |
271 |
$18K |
| A4335 |
Incontinence supply |
3,233 |
3,223 |
$14K |
| A6250 |
Skin seal protect moisturizr |
2,544 |
2,536 |
$13K |
| E0143 |
Walker folding wheeled w/o s |
387 |
387 |
$12K |
| A4927 |
Non-sterile gloves |
1,468 |
1,468 |
$7K |
| L0621 |
Sio flex pelvic/sacr pre ots |
134 |
134 |
$7K |
| T4524 |
Adult size brief/diaper xl |
109 |
109 |
$6K |
| E0245 |
Tub stool or bench |
113 |
113 |
$4K |
| A7005 |
Nondisposable nebulizer set |
273 |
272 |
$4K |
| A5500 |
Diab shoe for density insert |
56 |
42 |
$3K |
| E0156 |
Walker seat attachment |
223 |
223 |
$2K |
| A5512 |
Multi den insert direct form |
38 |
25 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
177 |
177 |
$173.32 |
| T4533 |
Youth size brief/diaper |
12 |
12 |
$121.80 |