| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
11,703 |
9,669 |
$2.98M |
| B4154 |
Ef spec metabolic noninherit |
3,399 |
3,271 |
$1.41M |
| T4528 |
Adult size pull-on xl |
8,674 |
8,382 |
$1.11M |
| T4543 |
Adult disp brief/diap abv xl |
3,658 |
3,478 |
$927K |
| T4541 |
Large disposable underpad |
6,883 |
6,645 |
$243K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,923 |
3,548 |
$157K |
| K0004 |
High strength ltwt whlchr |
3,789 |
3,487 |
$137K |
| E0247 |
Trans bench w/wo comm open |
1,822 |
1,692 |
$117K |
| T1999 |
Noc retail items andsupplies |
939 |
815 |
$88K |
| A4927 |
Non-sterile gloves |
4,168 |
4,017 |
$60K |
| A4670 |
Automatic bp monitor, dial |
1,602 |
1,571 |
$59K |
| K0003 |
Lightweight wheelchair |
1,289 |
1,218 |
$54K |
| E0245 |
Tub stool or bench |
1,394 |
1,349 |
$51K |
| E0143 |
Walker folding wheeled w/o s |
1,987 |
1,840 |
$47K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,297 |
1,178 |
$44K |
| E0243 |
Toilet rail |
1,130 |
1,040 |
$36K |
| E0627 |
Seat lift mech, electric any |
1,319 |
1,169 |
$34K |
| E0303 |
Hosp bed hvy dty xtra wide |
162 |
142 |
$28K |
| E0244 |
Toilet seat raised |
672 |
639 |
$27K |
| T4523 |
Adult size brief/diaper lg |
219 |
185 |
$27K |
| E0630 |
Patient lift hydraulic |
409 |
367 |
$21K |
| T4524 |
Adult size brief/diaper xl |
127 |
122 |
$19K |
| E0973 |
W/ch access det adj armrest |
340 |
281 |
$19K |
| E0163 |
Commode chair with fixed arm |
767 |
699 |
$18K |
| T4535 |
Disposable liner/shield/pad |
282 |
253 |
$17K |
| E0246 |
Transfer tub rail attachment |
355 |
344 |
$17K |
| T4522 |
Adult size brief/diaper med |
155 |
139 |
$16K |
| E0570 |
Nebulizer with compression |
1,145 |
1,101 |
$15K |
| E0241 |
Bath tub wall rail |
705 |
654 |
$14K |
| E0156 |
Walker seat attachment |
1,775 |
1,643 |
$12K |
| E0250 |
Hosp bed fixed ht w/ mattres |
945 |
940 |
$11K |
| E1031 |
Rollabout chair with casters |
585 |
536 |
$11K |
| T4537 |
Reusable underpad bed size |
94 |
91 |
$10K |
| E0159 |
Brake for wheeled walker |
1,293 |
1,202 |
$8K |
| T4544 |
Adlt disp und/pull on abv xl |
28 |
26 |
$8K |
| E0971 |
Wheelchair anti-tipping devi |
286 |
230 |
$7K |
| E0149 |
Heavy duty wheeled walker |
315 |
283 |
$6K |
| E2601 |
Gen w/c cushion wdth < 22 in |
285 |
258 |
$6K |
| E0185 |
Gel pressure mattress pad |
240 |
201 |
$5K |
| K0007 |
Extra heavy duty wheelchair |
132 |
119 |
$5K |
| E2611 |
Gen use back cush wdth <22in |
42 |
40 |
$4K |
| E0978 |
W/c acc,saf belt pelv strap |
232 |
208 |
$3K |
| E0951 |
Loop heel |
281 |
227 |
$3K |
| E0248 |
Hdtrans bench w/wo comm open |
32 |
25 |
$2K |
| E1038 |
Transport chair pt wt<=300lb |
259 |
254 |
$2K |
| A4357 |
Bedside drainage bag |
376 |
340 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
59 |
57 |
$354.67 |
| E0105 |
Cane adjust/fixed quad/3 pro |
12 |
12 |
$243.31 |
| A9270 |
Non-covered item or service |
730 |
518 |
$0.00 |
| A9286 |
Any hygienic item, device |
72 |
52 |
$0.00 |