| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult size pull-on xl |
968 |
938 |
$123K |
| T4541 |
Large disposable underpad |
2,300 |
2,267 |
$115K |
| T4527 |
Adult size pull-on lg |
585 |
576 |
$78K |
| T4535 |
Disposable liner/shield/pad |
964 |
945 |
$68K |
| A9276 |
Disposable sensor, cgm sys |
74 |
66 |
$56K |
| T4526 |
Adult size pull-on med |
346 |
343 |
$53K |
| A4927 |
Non-sterile gloves |
2,377 |
2,342 |
$46K |
| T4523 |
Adult size brief/diaper lg |
165 |
162 |
$20K |
| A4553 |
Nondisp underpads, all sizes |
228 |
225 |
$3K |
| T4537 |
Reusable underpad bed size |
145 |
144 |
$2K |
| E0570 |
Nebulizer with compression |
342 |
337 |
$2K |
| A4253 |
Blood glucose/reagent strips |
12 |
12 |
$47.84 |