| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment mi |
673 |
659 |
$199K |
| T4523 |
Adult size brief/diaper lg |
3,175 |
3,065 |
$186K |
| T4522 |
Adult size brief/diaper med |
3,341 |
3,240 |
$148K |
| A4554 |
Disposable underpads |
5,206 |
5,067 |
$118K |
| T4524 |
Adult size brief/diaper xl |
1,611 |
1,572 |
$104K |
| T4535 |
Disposable liner/shield/pad |
2,765 |
2,686 |
$59K |
| T4543 |
Adult disp brief/diap abv xl |
280 |
271 |
$35K |
| T4537 |
Reusable underpad bed size |
792 |
760 |
$26K |
| E0240 |
Bath/shower chair |
761 |
757 |
$26K |
| E0241 |
Bath tub wall rail |
702 |
688 |
$23K |
| A4670 |
Automatic bp monitor, dial |
415 |
413 |
$18K |
| E0143 |
Walker folding wheeled w/o s |
234 |
229 |
$18K |
| T4521 |
Adult size brief/diaper sm |
395 |
382 |
$15K |
| K0739 |
Repair/svc dme non-oxygen eq |
228 |
218 |
$14K |
| B4150 |
Ef complet w/intact nutrient |
181 |
168 |
$12K |
| E0163 |
Commode chair with fixed arm |
43 |
42 |
$4K |
| E0156 |
Walker seat attachment |
153 |
150 |
$3K |
| T4539 |
Reuse diaper/brief any size |
123 |
115 |
$2K |
| E1038 |
Transport chair pt wt<=300lb |
104 |
97 |
$2K |
| E0246 |
Transfer tub rail attachment |
42 |
42 |
$2K |
| E0244 |
Toilet seat raised |
89 |
86 |
$2K |
| E0245 |
Tub stool or bench |
64 |
64 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
133 |
132 |
$1K |
| A4927 |
Non-sterile gloves |
230 |
215 |
$1K |
| E0247 |
Trans bench w/wo comm open |
12 |
12 |
$907.28 |
| K0001 |
Standard wheelchair |
36 |
36 |
$714.17 |
| A4402 |
Lubricant per ounce |
25 |
24 |
$179.04 |