| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
27,899 |
27,589 |
$1.38M |
| T4540 |
Reusable underpad chair size |
17,445 |
17,178 |
$530K |
| T4523 |
Adult size brief/diaper lg |
6,115 |
5,990 |
$485K |
| T4541 |
Large disposable underpad |
19,724 |
19,440 |
$369K |
| T4522 |
Adult size brief/diaper med |
4,093 |
4,034 |
$322K |
| T4527 |
Adult size pull-on lg |
4,270 |
4,219 |
$308K |
| T4536 |
Reusable pull-on any size |
15,487 |
15,347 |
$297K |
| A4927 |
Non-sterile gloves |
17,985 |
16,964 |
$292K |
| T4526 |
Adult size pull-on med |
3,490 |
3,447 |
$266K |
| T4524 |
Adult size brief/diaper xl |
2,906 |
2,868 |
$254K |
| T4543 |
Adult disp brief/diap abv xl |
1,104 |
1,073 |
$230K |
| T4528 |
Adult size pull-on xl |
1,646 |
1,629 |
$150K |
| A4553 |
Nondisp underpads, all sizes |
1,917 |
1,912 |
$69K |
| A4554 |
Disposable underpads |
2,180 |
2,174 |
$64K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,865 |
1,804 |
$63K |
| K0004 |
High strength ltwt whlchr |
503 |
500 |
$22K |
| E0143 |
Walker folding wheeled w/o s |
729 |
717 |
$21K |
| T4521 |
Adult size brief/diaper sm |
240 |
240 |
$20K |
| K0001 |
Standard wheelchair |
1,695 |
1,647 |
$19K |
| A6530 |
Compression stocking bk18-30 |
367 |
209 |
$17K |
| A4335 |
Incontinence supply |
136 |
126 |
$14K |
| T4544 |
Adlt disp und/pull on abv xl |
67 |
66 |
$11K |
| E0570 |
Nebulizer with compression |
945 |
888 |
$11K |
| K0003 |
Lightweight wheelchair |
433 |
430 |
$10K |
| A6533 |
Gc stocking thighlngth 18-30 |
277 |
131 |
$9K |
| E0240 |
Bath/shower chair |
246 |
241 |
$9K |
| K0195 |
Elevating whlchair leg rests |
2,195 |
2,137 |
$8K |
| E1390 |
Oxygen concentrator |
208 |
205 |
$6K |
| T4525 |
Adult size pull-on sm |
47 |
47 |
$3K |
| A5500 |
Diab shoe for density insert |
70 |
62 |
$1K |
| E0163 |
Commode chair with fixed arm |
40 |
39 |
$949.31 |
| E0431 |
Portable gaseous 02 |
165 |
162 |
$869.70 |
| B4150 |
Ef complet w/intact nutrient |
12 |
12 |
$761.19 |
| A5512 |
Multi den insert direct form |
70 |
62 |
$407.10 |
| E0630 |
Patient lift hydraulic |
26 |
26 |
$396.82 |
| E2611 |
Gen use back cush wdth <22in |
12 |
12 |
$362.62 |
| E0156 |
Walker seat attachment |
54 |
54 |
$345.93 |
| E2601 |
Gen w/c cushion wdth < 22 in |
14 |
13 |
$167.56 |
| E0100 |
Cane adjust/fixed with tip |
12 |
12 |
$86.30 |
| E0971 |
Wheelchair anti-tipping devi |
15 |
12 |
$82.96 |