| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
5,746 |
5,434 |
$943K |
| T4535 |
Disposable liner/shield/pad |
15,150 |
14,298 |
$896K |
| T4526 |
Adult size pull-on med |
5,426 |
5,179 |
$876K |
| T4541 |
Large disposable underpad |
17,594 |
16,721 |
$850K |
| T4543 |
Adult disp brief/diap abv xl |
2,613 |
2,461 |
$804K |
| A4927 |
Non-sterile gloves |
19,860 |
18,770 |
$566K |
| T4528 |
Adult size pull-on xl |
3,207 |
3,035 |
$514K |
| T4523 |
Adult size brief/diaper lg |
1,282 |
1,193 |
$182K |
| E2611 |
Gen use back cush wdth <22in |
985 |
924 |
$98K |
| K0001 |
Standard wheelchair |
8,232 |
7,872 |
$88K |
| E0973 |
W/ch access det adj armrest |
2,118 |
1,208 |
$81K |
| T4525 |
Adult size pull-on sm |
472 |
452 |
$77K |
| K0195 |
Elevating whlchair leg rests |
8,265 |
7,874 |
$58K |
| E0971 |
Wheelchair anti-tipping devi |
1,875 |
1,082 |
$25K |
| A4553 |
Nondisp underpads, all sizes |
1,608 |
1,564 |
$24K |
| E0961 |
Wheelchair brake extension |
1,650 |
952 |
$17K |
| E2601 |
Gen w/c cushion wdth < 22 in |
957 |
895 |
$17K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,238 |
1,192 |
$17K |
| K0003 |
Lightweight wheelchair |
1,191 |
1,118 |
$16K |
| E0143 |
Walker folding wheeled w/o s |
620 |
589 |
$15K |
| T4537 |
Reusable underpad bed size |
862 |
811 |
$14K |
| E0630 |
Patient lift hydraulic |
642 |
600 |
$14K |
| K0006 |
Heavy duty wheelchair |
376 |
347 |
$14K |
| E0163 |
Commode chair with fixed arm |
217 |
209 |
$5K |
| K0002 |
Stnd hemi (low seat) whlchr |
870 |
852 |
$4K |
| E0165 |
Commode chair with detacharm |
123 |
123 |
$252.49 |