| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
8,576 |
7,457 |
$723K |
| T4527 |
Adult size pull-on lg |
6,013 |
5,735 |
$609K |
| T4528 |
Adult size pull-on xl |
4,198 |
3,997 |
$499K |
| T4526 |
Adult size pull-on med |
5,658 |
5,325 |
$481K |
| T4535 |
Disposable liner/shield/pad |
8,354 |
7,722 |
$471K |
| E1399 |
Durable medical equipment mi |
2,013 |
1,750 |
$231K |
| T4541 |
Large disposable underpad |
5,165 |
4,995 |
$225K |
| A4927 |
Non-sterile gloves |
6,525 |
6,435 |
$216K |
| T4523 |
Adult size brief/diaper lg |
1,370 |
1,277 |
$186K |
| T4522 |
Adult size brief/diaper med |
1,058 |
1,012 |
$119K |
| T4544 |
Adlt disp und/pull on abv xl |
613 |
590 |
$118K |
| T4534 |
Youth size pull-on |
356 |
337 |
$48K |
| E0260 |
Hosp bed semi-electr w/ matt |
551 |
549 |
$43K |
| B4150 |
Ef complet w/intact nutrient |
154 |
142 |
$19K |
| T4525 |
Adult size pull-on sm |
120 |
112 |
$12K |
| T4524 |
Adult size brief/diaper xl |
70 |
66 |
$11K |
| K0001 |
Standard wheelchair |
291 |
290 |
$7K |
| E0245 |
Tub stool or bench |
52 |
51 |
$6K |
| A4357 |
Bedside drainage bag |
402 |
303 |
$5K |
| E0570 |
Nebulizer with compression |
252 |
248 |
$3K |
| A6530 |
Compression stocking bk18-30 |
30 |
28 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
16 |
12 |
$173.09 |