| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
49,936 |
49,703 |
$3.24M |
| T4535 |
Disposable liner/shield/pad |
45,701 |
45,482 |
$2.89M |
| T4527 |
Adult size pull-on lg |
20,249 |
20,176 |
$2.40M |
| T4526 |
Adult size pull-on med |
16,144 |
16,087 |
$1.56M |
| A4927 |
Non-sterile gloves |
55,002 |
54,619 |
$1.17M |
| A9900 |
Supply/accessory/service |
58,234 |
57,966 |
$1.16M |
| A6250 |
Skin seal protect moisturizr |
43,149 |
42,832 |
$776K |
| T4528 |
Adult size pull-on xl |
5,285 |
5,252 |
$697K |
| A6545 |
Grad com non-elastic bk surg |
2,793 |
2,158 |
$639K |
| T4525 |
Adult size pull-on sm |
4,738 |
4,725 |
$459K |
| A4335 |
Incontinence supply |
32,992 |
32,846 |
$409K |
| T4536 |
Reusable pull-on any size |
33,540 |
33,382 |
$386K |
| T4537 |
Reusable underpad bed size |
5,363 |
5,278 |
$281K |
| T4523 |
Adult size brief/diaper lg |
1,942 |
1,933 |
$263K |
| T4524 |
Adult size brief/diaper xl |
1,365 |
1,361 |
$184K |
| K0003 |
Lightweight wheelchair |
3,040 |
3,019 |
$175K |
| E0295 |
Hosp bed semi-elect w/o matt |
2,838 |
2,822 |
$160K |
| E0245 |
Tub stool or bench |
2,076 |
2,075 |
$129K |
| E0143 |
Walker folding wheeled w/o s |
2,447 |
2,430 |
$93K |
| T4522 |
Adult size brief/diaper med |
860 |
856 |
$89K |
| K0001 |
Standard wheelchair |
2,383 |
2,370 |
$61K |
| E1038 |
Transport chair pt wt<=300lb |
6,273 |
6,257 |
$51K |
| E0163 |
Commode chair with fixed arm |
1,193 |
1,191 |
$42K |
| E2611 |
Gen use back cush wdth <22in |
292 |
290 |
$34K |
| K0002 |
Stnd hemi (low seat) whlchr |
603 |
598 |
$29K |
| E0630 |
Patient lift hydraulic |
643 |
633 |
$27K |
| E0305 |
Rails bed side half length |
2,825 |
2,805 |
$25K |
| A5512 |
Multi den insert direct form |
394 |
274 |
$18K |
| E0971 |
Wheelchair anti-tipping devi |
474 |
424 |
$17K |
| E0277 |
Powered pres-redu air mattrs |
126 |
125 |
$16K |
| E0156 |
Walker seat attachment |
1,033 |
1,028 |
$12K |
| A5500 |
Diab shoe for density insert |
380 |
265 |
$11K |
| E0961 |
Wheelchair brake extension |
453 |
402 |
$10K |
| A4670 |
Automatic bp monitor, dial |
273 |
273 |
$10K |
| E0951 |
Loop heel |
449 |
399 |
$7K |
| L1831 |
Knee orth pos locking joint |
47 |
31 |
$7K |
| E2601 |
Gen w/c cushion wdth < 22 in |
284 |
283 |
$6K |
| E0978 |
W/c acc,saf belt pelv strap |
403 |
401 |
$6K |
| E0247 |
Trans bench w/wo comm open |
52 |
52 |
$5K |
| E0100 |
Cane adjust/fixed with tip |
453 |
453 |
$5K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
26 |
26 |
$4K |
| E0570 |
Nebulizer with compression |
40 |
40 |
$2K |
| E0241 |
Bath tub wall rail |
38 |
38 |
$1K |
| E0185 |
Gel pressure mattress pad |
12 |
12 |
$1K |
| E0255 |
Hospital bed var ht w/ mattr |
210 |
210 |
$948.51 |
| E0271 |
Mattress innerspring |
14 |
14 |
$883.14 |
| E0105 |
Cane adjust/fixed quad/3 pro |
39 |
39 |
$831.32 |
| A7013 |
Disposable compressor filter |
572 |
572 |
$628.58 |
| A7015 |
Aerosol mask used w nebulize |
577 |
575 |
$569.38 |
| A7003 |
Nebulizer administration set |
396 |
394 |
$331.56 |
| K0195 |
Elevating whlchair leg rests |
24 |
24 |
$117.84 |