| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
10,864 |
10,692 |
$1.53M |
| A4554 |
Disposable underpads |
35,258 |
34,717 |
$1.32M |
| T4526 |
Adult size pull-on med |
8,008 |
7,942 |
$989K |
| T4528 |
Adult size pull-on xl |
4,216 |
4,176 |
$692K |
| T4535 |
Disposable liner/shield/pad |
13,759 |
13,434 |
$579K |
| T4524 |
Adult size brief/diaper xl |
1,981 |
1,963 |
$284K |
| T4523 |
Adult size brief/diaper lg |
2,147 |
2,128 |
$246K |
| A4335 |
Incontinence supply |
40,424 |
39,755 |
$229K |
| T4522 |
Adult size brief/diaper med |
1,972 |
1,902 |
$208K |
| B4150 |
Ef complet w/intact nutrient |
521 |
489 |
$111K |
| E1399 |
Durable medical equipment mi |
130 |
118 |
$83K |
| T4534 |
Youth size pull-on |
765 |
669 |
$83K |
| T4544 |
Adlt disp und/pull on abv xl |
425 |
413 |
$80K |
| A4253 |
Blood glucose/reagent strips |
4,243 |
4,097 |
$70K |
| T4530 |
Ped size brief/diaper lg |
635 |
580 |
$56K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,024 |
2,016 |
$43K |
| E0240 |
Bath/shower chair |
85 |
83 |
$40K |
| T4525 |
Adult size pull-on sm |
401 |
360 |
$35K |
| K0001 |
Standard wheelchair |
2,561 |
2,553 |
$31K |
| B4154 |
Ef spec metabolic noninherit |
39 |
39 |
$21K |
| T4543 |
Adult disp brief/diap abv xl |
115 |
103 |
$20K |
| E0630 |
Patient lift hydraulic |
593 |
587 |
$13K |
| A4259 |
Lancets per box |
3,516 |
3,459 |
$13K |
| E0570 |
Nebulizer with compression |
746 |
741 |
$8K |
| K0003 |
Lightweight wheelchair |
531 |
531 |
$7K |
| A4245 |
Alcohol wipes per box |
2,604 |
2,564 |
$4K |
| A4670 |
Automatic bp monitor, dial |
40 |
38 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
25 |
25 |
$538.76 |
| E2601 |
Gen w/c cushion wdth < 22 in |
15 |
14 |
$291.02 |