| Code | Description | Claims | Beneficiaries | Total Paid |
| T4541 |
Large disposable underpad |
68,049 |
67,975 |
$3.59M |
| T4535 |
Disposable liner/shield/pad |
47,039 |
46,943 |
$2.42M |
| T4527 |
Adult size pull-on lg |
18,949 |
18,939 |
$1.33M |
| T4526 |
Adult size pull-on med |
18,089 |
18,077 |
$1.06M |
| T4528 |
Adult size pull-on xl |
11,284 |
11,275 |
$779K |
| T4523 |
Adult size brief/diaper lg |
8,989 |
8,984 |
$717K |
| T4524 |
Adult size brief/diaper xl |
9,428 |
9,424 |
$696K |
| T4537 |
Reusable underpad bed size |
5,241 |
5,235 |
$298K |
| A6250 |
Skin seal protect moisturizr |
35,927 |
35,896 |
$291K |
| T4522 |
Adult size brief/diaper med |
3,185 |
3,181 |
$260K |
| E1390 |
Oxygen concentrator |
3,577 |
3,558 |
$210K |
| A4335 |
Incontinence supply |
36,595 |
36,525 |
$186K |
| T4525 |
Adult size pull-on sm |
3,054 |
3,050 |
$166K |
| E0277 |
Powered pres-redu air mattrs |
2,955 |
2,206 |
$122K |
| T4536 |
Reusable pull-on any size |
9,424 |
9,412 |
$111K |
| K0003 |
Lightweight wheelchair |
4,510 |
4,445 |
$111K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,000 |
3,945 |
$78K |
| E0295 |
Hosp bed semi-elect w/o matt |
3,032 |
3,030 |
$76K |
| E0245 |
Tub stool or bench |
706 |
705 |
$38K |
| E0635 |
Patient lift electric |
1,061 |
1,059 |
$35K |
| E0431 |
Portable gaseous 02 |
3,186 |
3,174 |
$33K |
| E0185 |
Gel pressure mattress pad |
558 |
554 |
$31K |
| E0630 |
Patient lift hydraulic |
942 |
909 |
$18K |
| E2611 |
Gen use back cush wdth <22in |
97 |
97 |
$12K |
| E0143 |
Walker folding wheeled w/o s |
245 |
241 |
$12K |
| E0971 |
Wheelchair anti-tipping devi |
96 |
96 |
$4K |
| E0443 |
Portable 02 contents, gas |
72 |
65 |
$4K |
| E2601 |
Gen w/c cushion wdth < 22 in |
97 |
97 |
$3K |
| E0305 |
Rails bed side half length |
89 |
89 |
$1K |
| E0247 |
Trans bench w/wo comm open |
13 |
13 |
$1K |
| E0910 |
Trapeze bar attached to bed |
222 |
209 |
$948.19 |
| E0261 |
Hosp bed semi-electr w/o mat |
28 |
27 |
$639.17 |
| A4456 |
Adhesive remover, wipes |
69 |
69 |
$621.20 |
| A4927 |
Non-sterile gloves |
209 |
206 |
$518.50 |
| K0001 |
Standard wheelchair |
14 |
14 |
$429.38 |
| Q0513 |
Disp fee inhal drugs/30 days |
37 |
37 |
$290.06 |
| E0601 |
Cont airway pressure device |
79 |
79 |
$159.48 |
| K0195 |
Elevating whlchair leg rests |
41 |
41 |
$154.72 |
| E0570 |
Nebulizer with compression |
14 |
14 |
$11.48 |
| A7005 |
Nondisposable nebulizer set |
13 |
13 |
$0.00 |