| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4537 |
Reusable underpad bed size |
59,663 |
57,117 |
$2.03M |
| T4527 |
Adult size pull-on lg |
21,562 |
20,510 |
$1.91M |
| A4927 |
Non-sterile gloves |
110,829 |
103,356 |
$1.59M |
| T4526 |
Adult size pull-on med |
18,304 |
17,520 |
$1.47M |
| T4535 |
Disposable liner/shield/pad |
37,637 |
35,976 |
$1.35M |
| T4528 |
Adult size pull-on xl |
13,529 |
12,714 |
$1.29M |
| T4523 |
Adult size brief/diaper lg |
9,765 |
9,477 |
$1.07M |
| E1399 |
Durable medical equipment mi |
3,773 |
3,560 |
$1.05M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,097 |
3,993 |
$1.01M |
| T4543 |
Adult disp brief/diap abv xl |
3,955 |
3,739 |
$857K |
| T4534 |
Youth size pull-on |
7,981 |
7,806 |
$850K |
| T4541 |
Large disposable underpad |
40,080 |
37,273 |
$766K |
| T4544 |
Adlt disp und/pull on abv xl |
4,561 |
4,383 |
$756K |
| T4522 |
Adult size brief/diaper med |
7,370 |
7,103 |
$584K |
| A4554 |
Disposable underpads |
37,040 |
36,104 |
$553K |
| T4524 |
Adult size brief/diaper xl |
4,993 |
4,765 |
$518K |
| A4553 |
Nondisp underpads, all sizes |
12,172 |
11,530 |
$438K |
| B4100 |
Food thickener oral |
7,114 |
6,570 |
$330K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,120 |
2,809 |
$312K |
| T4525 |
Adult size pull-on sm |
3,846 |
3,719 |
$311K |
| A4500 |
Below knee surgical stocking |
7,643 |
7,304 |
$299K |
| B4150 |
Ef complet w/intact nutrient |
2,980 |
2,666 |
$286K |
| B4035 |
Enteral feed supp pump per d |
5,963 |
1,860 |
$205K |
| B4154 |
Ef spec metabolic noninherit |
1,231 |
1,033 |
$185K |
| B9998 |
Enteral supp not otherwise c |
464 |
415 |
$157K |
| A6530 |
Compression stocking bk18-30 |
2,929 |
2,568 |
$143K |
| E0570 |
Nebulizer with compression |
5,788 |
5,518 |
$131K |
| T4540 |
Reusable underpad chair size |
3,689 |
3,630 |
$117K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,007 |
3,909 |
$103K |
| A4670 |
Automatic bp monitor, dial |
1,664 |
1,653 |
$88K |
| T4521 |
Adult size brief/diaper sm |
909 |
896 |
$68K |
| W0137 |
|
293 |
273 |
$61K |
| K0001 |
Standard wheelchair |
3,340 |
3,276 |
$43K |
| B9002 |
Enter nutr inf pump any type |
1,036 |
1,003 |
$41K |
| E0240 |
Bath/shower chair |
1,399 |
1,302 |
$39K |
| E0143 |
Walker folding wheeled w/o s |
1,475 |
1,438 |
$37K |
| A4335 |
Incontinence supply |
2,606 |
2,402 |
$37K |
| E0265 |
Hosp bed total electr w/ mat |
611 |
583 |
$28K |
| E0250 |
Hosp bed fixed ht w/ mattres |
1,459 |
1,428 |
$26K |
| E0630 |
Patient lift hydraulic |
1,139 |
1,091 |
$16K |
| K0003 |
Lightweight wheelchair |
1,116 |
1,107 |
$15K |
| A4253 |
Blood glucose/reagent strips |
2,340 |
2,170 |
$15K |
| A7031 |
Replacement facemask interfa |
439 |
427 |
$11K |
| A7005 |
Nondisposable nebulizer set |
980 |
934 |
$10K |
| E0627 |
Seat lift mech, electric any |
90 |
88 |
$9K |
| E0601 |
Cont airway pressure device |
297 |
293 |
$9K |
| A4351 |
Straight tip urine catheter |
83 |
76 |
$8K |
| E0156 |
Walker seat attachment |
1,359 |
1,336 |
$7K |
| E0149 |
Heavy duty wheeled walker |
894 |
872 |
$7K |
| K0553 |
Ther cgm supply allowance |
76 |
74 |
$7K |
| E2611 |
Gen use back cush wdth <22in |
76 |
73 |
$6K |
| E0971 |
Wheelchair anti-tipping devi |
250 |
212 |
$5K |
| E0163 |
Commode chair with fixed arm |
211 |
208 |
$5K |
| B4161 |
Ef ped hydrolyzed/amino acid |
12 |
12 |
$4K |
| L3908 |
Who cock-up nonmolde pre ots |
130 |
85 |
$4K |
| A7038 |
Pos airway pressure filter |
1,071 |
1,037 |
$4K |
| A4660 |
Sphyg/bp app w cuff and stet |
146 |
144 |
$4K |
| E2601 |
Gen w/c cushion wdth < 22 in |
203 |
195 |
$4K |
| E0303 |
Hosp bed hvy dty xtra wide |
36 |
36 |
$4K |
| K0006 |
Heavy duty wheelchair |
103 |
102 |
$3K |
| A7030 |
Cpap full face mask |
40 |
40 |
$3K |
| E1038 |
Transport chair pt wt<=300lb |
676 |
663 |
$3K |
| K0195 |
Elevating whlchair leg rests |
869 |
844 |
$3K |
| A4357 |
Bedside drainage bag |
1,184 |
1,099 |
$2K |
| E0244 |
Toilet seat raised |
56 |
53 |
$2K |
| E0277 |
Powered pres-redu air mattrs |
41 |
39 |
$2K |
| A7003 |
Nebulizer administration set |
2,090 |
1,818 |
$2K |
| A4216 |
Sterile water/saline, 10 ml |
92 |
62 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
2,715 |
2,476 |
$2K |
| E0165 |
Commode chair with detacharm |
325 |
319 |
$2K |
| A4358 |
Urinary leg or abdomen bag |
962 |
912 |
$1K |
| A4259 |
Lancets per box |
2,221 |
2,063 |
$1K |
| A4314 |
Cath w/drainage 2-way latex |
254 |
243 |
$1K |
| E0100 |
Cane adjust/fixed with tip |
155 |
155 |
$1K |
| A4520 |
Incontinence garment anytype |
1,134 |
710 |
$992.04 |
| A5120 |
Skin barrier, wipe or swab |
303 |
278 |
$920.30 |
| A6533 |
Gc stocking thighlngth 18-30 |
15 |
13 |
$899.35 |
| Q0513 |
Disp fee inhal drugs/30 days |
343 |
319 |
$857.86 |
| A7037 |
Pos airway pressure tubing |
60 |
56 |
$685.26 |
| A5500 |
Diab shoe for density insert |
27 |
27 |
$652.26 |
| A6402 |
Sterile gauze <= 16 sq in |
163 |
156 |
$521.82 |
| A7035 |
Pos airway press headgear |
44 |
44 |
$520.76 |
| A4239 |
Non-adju cgm supply allow |
40 |
39 |
$314.50 |
| J7613 |
Albuterol non-comp unit |
80 |
79 |
$223.35 |
| E0105 |
Cane adjust/fixed quad/3 pro |
12 |
12 |
$169.16 |
| A5512 |
Multi den insert direct form |
14 |
14 |
$153.75 |
| A7039 |
Filter, non disposable w pap |
15 |
15 |
$97.00 |
| A7046 |
Repl water chamber, pap dev |
13 |
13 |
$85.92 |
| B4087 |
Gastro/jejuno tube, std |
12 |
12 |
$61.56 |