| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
140,214 |
138,716 |
$7.46M |
| T4535 |
Disposable liner/shield/pad |
94,444 |
90,360 |
$5.41M |
| T4523 |
Adult size brief/diaper lg |
31,010 |
30,687 |
$3.17M |
| T4526 |
Adult size pull-on med |
55,809 |
55,247 |
$2.99M |
| T4527 |
Adult size pull-on lg |
33,311 |
32,912 |
$2.09M |
| T4524 |
Adult size brief/diaper xl |
12,829 |
12,619 |
$1.16M |
| T4522 |
Adult size brief/diaper med |
11,619 |
11,493 |
$807K |
| T4528 |
Adult size pull-on xl |
11,478 |
11,337 |
$718K |
| T4525 |
Adult size pull-on sm |
12,227 |
12,057 |
$648K |
| T4537 |
Reusable underpad bed size |
18,875 |
18,656 |
$491K |
| A4927 |
Non-sterile gloves |
32,662 |
31,873 |
$431K |
| E0261 |
Hosp bed semi-electr w/o mat |
18,061 |
14,221 |
$219K |
| E0245 |
Tub stool or bench |
3,299 |
3,297 |
$192K |
| K0001 |
Standard wheelchair |
20,027 |
19,465 |
$169K |
| K0002 |
Stnd hemi (low seat) whlchr |
15,603 |
10,103 |
$118K |
| E0143 |
Walker folding wheeled w/o s |
8,786 |
7,467 |
$117K |
| E1390 |
Oxygen concentrator |
3,522 |
3,502 |
$87K |
| T4521 |
Adult size brief/diaper sm |
1,260 |
1,242 |
$75K |
| K0816 |
Pwc gp 1 std cap chair |
3,839 |
1,979 |
$71K |
| E2611 |
Gen use back cush wdth <22in |
2,651 |
2,096 |
$69K |
| B4154 |
Ef spec metabolic noninherit |
752 |
685 |
$67K |
| K0003 |
Lightweight wheelchair |
5,027 |
4,999 |
$65K |
| E0630 |
Patient lift hydraulic |
4,720 |
3,884 |
$64K |
| A6250 |
Skin seal protect moisturizr |
4,276 |
4,267 |
$57K |
| B4034 |
Enter feed supkit syr by day |
2,181 |
1,995 |
$52K |
| E1038 |
Transport chair pt wt<=300lb |
13,258 |
12,574 |
$52K |
| E0295 |
Hosp bed semi-elect w/o matt |
2,439 |
2,438 |
$52K |
| B4035 |
Enteral feed supp pump per d |
1,779 |
1,621 |
$49K |
| E0184 |
Dry pressure mattress |
2,155 |
1,817 |
$47K |
| A4335 |
Incontinence supply |
4,371 |
4,367 |
$40K |
| B4150 |
Ef complet w/intact nutrient |
779 |
715 |
$37K |
| B4152 |
Ef calorie dense>/=1.5kcal |
835 |
772 |
$25K |
| E0600 |
Suction pump portab hom modl |
2,096 |
1,992 |
$23K |
| E2601 |
Gen w/c cushion wdth < 22 in |
3,014 |
2,444 |
$21K |
| E0156 |
Walker seat attachment |
5,665 |
4,565 |
$19K |
| E0951 |
Loop heel |
4,057 |
3,391 |
$18K |
| E0431 |
Portable gaseous 02 |
3,481 |
3,463 |
$17K |
| E0277 |
Powered pres-redu air mattrs |
604 |
441 |
$13K |
| T4536 |
Reusable pull-on any size |
1,317 |
1,310 |
$13K |
| E0570 |
Nebulizer with compression |
8,276 |
7,796 |
$12K |
| A4239 |
Non-adju cgm supply allow |
216 |
215 |
$11K |
| K0195 |
Elevating whlchair leg rests |
4,328 |
3,668 |
$11K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
429 |
359 |
$11K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,430 |
718 |
$8K |
| E0265 |
Hosp bed total electr w/ mat |
579 |
563 |
$8K |
| E0163 |
Commode chair with fixed arm |
489 |
372 |
$6K |
| E0973 |
W/ch access det adj armrest |
426 |
290 |
$6K |
| B9002 |
Enter nutr inf pump any type |
309 |
307 |
$5K |
| K0006 |
Heavy duty wheelchair |
615 |
379 |
$5K |
| K0007 |
Extra heavy duty wheelchair |
351 |
240 |
$4K |
| K0739 |
Repair/svc dme non-oxygen eq |
507 |
211 |
$4K |
| A7000 |
Disposable canister for pump |
622 |
586 |
$3K |
| A4628 |
Oropharyngeal suction cath |
609 |
590 |
$3K |
| E0978 |
W/c acc,saf belt pelv strap |
1,146 |
635 |
$3K |
| E0971 |
Wheelchair anti-tipping devi |
272 |
258 |
$3K |
| E0149 |
Heavy duty wheeled walker |
1,534 |
960 |
$3K |
| E0955 |
Cushioned headrest |
921 |
871 |
$3K |
| Q0513 |
Disp fee inhal drugs/30 days |
363 |
349 |
$2K |
| E0961 |
Wheelchair brake extension |
417 |
292 |
$2K |
| E0601 |
Cont airway pressure device |
221 |
219 |
$2K |
| A4604 |
Tubing with heating element |
158 |
158 |
$2K |
| E0105 |
Cane adjust/fixed quad/3 pro |
174 |
106 |
$1K |
| E2365 |
U1 sealed leadacid battery |
91 |
45 |
$1K |
| A7002 |
Tubing used w suction pump |
581 |
553 |
$1K |
| A7038 |
Pos airway pressure filter |
163 |
163 |
$601.38 |
| E0776 |
Iv pole |
333 |
331 |
$450.92 |
| A4253 |
Blood glucose/reagent strips |
82 |
76 |
$414.60 |
| E0305 |
Rails bed side half length |
50 |
50 |
$410.65 |
| L1812 |
Ko elastic w/joints pre ots |
31 |
12 |
$377.28 |
| A7003 |
Nebulizer administration set |
768 |
616 |
$360.61 |
| A7015 |
Aerosol mask used w nebulize |
762 |
728 |
$329.15 |
| A7005 |
Nondisposable nebulizer set |
194 |
135 |
$327.19 |
| E0100 |
Cane adjust/fixed with tip |
72 |
48 |
$261.64 |
| A7013 |
Disposable compressor filter |
416 |
343 |
$235.79 |
| J7613 |
Albuterol non-comp unit |
29 |
28 |
$122.02 |
| A7035 |
Pos airway press headgear |
12 |
12 |
$73.29 |
| A4259 |
Lancets per box |
56 |
51 |
$61.10 |
| B4087 |
Gastro/jejuno tube, std |
25 |
25 |
$0.00 |