| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads |
121,248 |
115,533 |
$7.45M |
| T4527 |
Adult size pull-on lg |
45,204 |
43,261 |
$7.26M |
| T4526 |
Adult size pull-on med |
44,874 |
42,869 |
$6.54M |
| A4927 |
Non-sterile gloves |
131,192 |
124,798 |
$6.10M |
| T4528 |
Adult size pull-on xl |
19,920 |
19,110 |
$3.20M |
| T4544 |
Adlt disp und/pull on abv xl |
6,944 |
6,546 |
$1.56M |
| A4335 |
Incontinence supply |
118,143 |
112,661 |
$1.05M |
| T4543 |
Adult disp brief/diap abv xl |
2,882 |
2,689 |
$616K |
| T4523 |
Adult size brief/diaper lg |
4,763 |
4,483 |
$548K |
| T4525 |
Adult size pull-on sm |
4,081 |
3,842 |
$493K |
| T4522 |
Adult size brief/diaper med |
2,560 |
2,451 |
$337K |
| T4524 |
Adult size brief/diaper xl |
2,226 |
2,095 |
$281K |
| A4253 |
Blood glucose/reagent strips |
7,973 |
6,443 |
$43K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,873 |
1,580 |
$33K |
| K0001 |
Standard wheelchair |
5,615 |
3,126 |
$28K |
| A4256 |
Calibrator solution/chips |
6,851 |
5,569 |
$3K |
| E0607 |
Blood glucose monitor home |
344 |
192 |
$2K |
| E0185 |
Gel pressure mattress pad |
23 |
12 |
$45.52 |