| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
102,680 |
91,781 |
$2.94M |
| T4526 |
Adult size pull-on med |
32,149 |
28,694 |
$2.22M |
| T4527 |
Adult size pull-on lg |
32,846 |
29,316 |
$2.21M |
| T4528 |
Adult size pull-on xl |
22,277 |
19,821 |
$1.83M |
| T4523 |
Adult size brief/diaper lg |
17,577 |
15,866 |
$1.16M |
| T4524 |
Adult size brief/diaper xl |
13,683 |
12,317 |
$1.13M |
| T4535 |
Disposable liner/shield/pad |
45,956 |
40,970 |
$1.01M |
| T4522 |
Adult size brief/diaper med |
18,084 |
16,045 |
$931K |
| T4525 |
Adult size pull-on sm |
11,773 |
10,487 |
$806K |
| T4544 |
Adlt disp und/pull on abv xl |
3,546 |
3,287 |
$524K |
| T4521 |
Adult size brief/diaper sm |
5,910 |
5,264 |
$324K |
| E2361 |
22nf sealed leadacid battery |
1,245 |
1,180 |
$261K |
| E2366 |
Battery charger, single mode |
1,215 |
1,156 |
$202K |
| A5120 |
Skin barrier, wipe or swab |
16,348 |
15,241 |
$146K |
| A4612 |
Battery cables |
1,237 |
1,174 |
$81K |
| E2387 |
Foam filled caster tire |
803 |
773 |
$78K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,314 |
1,233 |
$73K |
| E0245 |
Tub stool or bench |
1,170 |
955 |
$69K |
| E2386 |
Foam filled drive wheel tire |
275 |
249 |
$55K |
| A4670 |
Automatic bp monitor, dial |
1,125 |
970 |
$44K |
| K0815 |
Pwc gp 1 std seat/back |
13 |
13 |
$43K |
| E2365 |
U1 sealed leadacid battery |
149 |
131 |
$20K |
| E0982 |
Back upholstery, replacement |
243 |
223 |
$9K |
| E0141 |
Rigid wheeled walker adj/fix |
106 |
96 |
$8K |
| E0981 |
Seat upholstery, replacement |
219 |
203 |
$8K |
| E0978 |
W/c acc,saf belt pelv strap |
330 |
304 |
$8K |
| E0244 |
Toilet seat raised |
219 |
180 |
$8K |
| E0994 |
Wheelchair arm rest |
210 |
193 |
$7K |
| K0042 |
Standard size ftplate rep ea |
106 |
102 |
$6K |
| K0019 |
Arm pad repl, each |
201 |
184 |
$5K |
| A5500 |
Diab shoe for density insert |
147 |
83 |
$5K |
| K0800 |
Pov group 1 std up to 300lbs |
16 |
13 |
$4K |
| E0570 |
Nebulizer with compression |
117 |
99 |
$4K |
| A5513 |
Multi den insert custom mold |
90 |
50 |
$3K |
| E0163 |
Commode chair with fixed arm |
68 |
54 |
$2K |
| L1820 |
Ko elas w/ condyle pads & jo |
21 |
12 |
$2K |
| E0973 |
W/ch access det adj armrest |
15 |
14 |
$2K |
| A4927 |
Non-sterile gloves |
296 |
281 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
59 |
47 |
$1K |
| A4456 |
Adhesive remover, wipes |
24 |
24 |
$277.31 |
| E0156 |
Walker seat attachment |
60 |
56 |
$141.59 |
| A7013 |
Disposable compressor filter |
40 |
37 |
$15.78 |