| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
28,995 |
28,597 |
$3.01M |
| T4534 |
Youth size pull-on |
14,672 |
13,963 |
$2.53M |
| T4541 |
Large disposable underpad |
34,070 |
33,421 |
$2.18M |
| E0601 |
Cont airway pressure device |
21,378 |
20,694 |
$1.67M |
| T4526 |
Adult size pull-on med |
13,655 |
13,326 |
$1.59M |
| T4527 |
Adult size pull-on lg |
13,952 |
13,786 |
$1.58M |
| E1390 |
Oxygen concentrator |
6,765 |
6,087 |
$1.21M |
| T4530 |
Ped size brief/diaper lg |
6,765 |
6,445 |
$1.19M |
| A7030 |
Cpap full face mask |
8,891 |
8,576 |
$1.08M |
| A7031 |
Replacement facemask interfa |
7,674 |
7,564 |
$1.07M |
| T4528 |
Adult size pull-on xl |
7,251 |
7,122 |
$844K |
| A4604 |
Tubing with heating element |
13,718 |
13,186 |
$672K |
| B9998 |
Enteral supp not otherwise c |
1,679 |
956 |
$667K |
| T4523 |
Adult size brief/diaper lg |
4,011 |
3,893 |
$591K |
| A7032 |
Replacement nasal cushion |
3,354 |
3,302 |
$523K |
| T4522 |
Adult size brief/diaper med |
3,203 |
3,085 |
$494K |
| E0562 |
Humidifier heated used w pap |
2,558 |
2,405 |
$444K |
| A7034 |
Nasal application device |
6,113 |
5,910 |
$416K |
| A4606 |
Oxygen probe used w oximeter |
473 |
451 |
$300K |
| T4524 |
Adult size brief/diaper xl |
2,078 |
2,046 |
$287K |
| T4525 |
Adult size pull-on sm |
2,432 |
2,398 |
$279K |
| A7038 |
Pos airway pressure filter |
14,309 |
13,986 |
$268K |
| E1399 |
Durable medical equipment mi |
1,583 |
1,492 |
$259K |
| A7033 |
Replacement nasal pillows |
1,943 |
1,917 |
$231K |
| K0001 |
Standard wheelchair |
3,748 |
3,431 |
$230K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,031 |
988 |
$221K |
| A7035 |
Pos airway press headgear |
8,811 |
8,408 |
$219K |
| E0570 |
Nebulizer with compression |
2,257 |
2,104 |
$211K |
| T4544 |
Adlt disp und/pull on abv xl |
1,621 |
1,601 |
$176K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,343 |
1,188 |
$172K |
| K0738 |
Portable gas oxygen system |
3,692 |
3,226 |
$163K |
| L4361 |
Pneuma/vac walk boot pre ots |
417 |
409 |
$163K |
| E0240 |
Bath/shower chair |
1,951 |
1,873 |
$149K |
| A4927 |
Non-sterile gloves |
6,342 |
6,188 |
$146K |
| L3908 |
Who cock-up nonmolde pre ots |
1,588 |
1,120 |
$131K |
| B4035 |
Enteral feed supp pump per d |
833 |
747 |
$121K |
| E0247 |
Trans bench w/wo comm open |
698 |
667 |
$114K |
| E0470 |
Rad w/o backup non-inv intfc |
668 |
653 |
$101K |
| E0465 |
Home vent invasive interface |
66 |
60 |
$99K |
| A7046 |
Repl water chamber, pap dev |
6,497 |
6,285 |
$95K |
| E0445 |
Oximeter non-invasive |
427 |
416 |
$89K |
| A4670 |
Automatic bp monitor, dial |
304 |
205 |
$89K |
| T4543 |
Adult disp brief/diap abv xl |
660 |
640 |
$89K |
| E0143 |
Walker folding wheeled w/o s |
1,034 |
913 |
$87K |
| K0004 |
High strength ltwt whlchr |
761 |
657 |
$87K |
| E0431 |
Portable gaseous 02 |
1,717 |
1,561 |
$85K |
| B4150 |
Ef complet w/intact nutrient |
580 |
542 |
$84K |
| L4350 |
Ankle control ortho pre ots |
689 |
606 |
$76K |
| T2028 |
Special supply, nos waiver |
1,394 |
1,235 |
$73K |
| T4521 |
Adult size brief/diaper sm |
383 |
337 |
$68K |
| A4649 |
Surgical supplies |
173 |
120 |
$67K |
| T4532 |
Ped size pull-on lg |
354 |
322 |
$58K |
| E0114 |
Crutch underarm pair no wood |
2,004 |
1,839 |
$55K |
| L3660 |
So 8 ab rstr can/web pre ots |
309 |
306 |
$44K |
| E0244 |
Toilet seat raised |
673 |
644 |
$42K |
| A4351 |
Straight tip urine catheter |
175 |
170 |
$42K |
| A7000 |
Disposable canister for pump |
909 |
800 |
$42K |
| A7526 |
Tracheostomy tube collar |
460 |
409 |
$39K |
| E0600 |
Suction pump portab hom modl |
839 |
749 |
$39K |
| A7005 |
Nondisposable nebulizer set |
1,174 |
1,069 |
$30K |
| K0195 |
Elevating whlchair leg rests |
2,467 |
2,257 |
$30K |
| E0241 |
Bath tub wall rail |
769 |
745 |
$29K |
| A4217 |
Sterile water/saline, 500 ml |
458 |
373 |
$27K |
| E0466 |
Home vent non-invasive inter |
31 |
25 |
$26K |
| A7037 |
Pos airway pressure tubing |
981 |
975 |
$25K |
| A6530 |
Compression stocking bk18-30 |
162 |
159 |
$21K |
| L1830 |
Ko immob canvas long pre ots |
197 |
181 |
$18K |
| A4629 |
Tracheostomy care kit |
156 |
127 |
$16K |
| E1038 |
Transport chair pt wt<=300lb |
575 |
546 |
$14K |
| B4152 |
Ef calorie dense>/=1.5kcal |
65 |
61 |
$13K |
| L1820 |
Ko elas w/ condyle pads & jo |
72 |
66 |
$11K |
| E0156 |
Walker seat attachment |
369 |
325 |
$9K |
| A6533 |
Gc stocking thighlngth 18-30 |
73 |
69 |
$8K |
| A4628 |
Oropharyngeal suction cath |
691 |
594 |
$8K |
| A6402 |
Sterile gauze <= 16 sq in |
529 |
427 |
$7K |
| A7002 |
Tubing used w suction pump |
879 |
783 |
$7K |
| L3807 |
Whfo w/o joints pre cst |
26 |
26 |
$6K |
| A4624 |
Tracheal suction tube |
40 |
39 |
$6K |
| A7039 |
Filter, non disposable w pap |
552 |
541 |
$6K |
| E0243 |
Toilet rail |
82 |
81 |
$6K |
| A4627 |
Spacer bag/reservoir |
429 |
392 |
$6K |
| E0163 |
Commode chair with fixed arm |
52 |
50 |
$4K |
| A7507 |
Integrated filter & holder |
26 |
26 |
$3K |
| E0246 |
Transfer tub rail attachment |
43 |
40 |
$2K |
| A7003 |
Nebulizer administration set |
694 |
669 |
$2K |
| A4450 |
Non-waterproof tape |
322 |
252 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
228 |
186 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
727 |
662 |
$1K |
| E0100 |
Cane adjust/fixed with tip |
50 |
37 |
$603.50 |
| A7036 |
Pos airway press chinstrap |
38 |
38 |
$392.16 |