| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
4,443 |
3,717 |
$1.08M |
| T4528 |
Adult size pull-on xl |
4,426 |
4,175 |
$410K |
| B4154 |
Ef spec metabolic noninherit |
1,584 |
1,448 |
$286K |
| T4543 |
Adult disp brief/diap abv xl |
1,518 |
1,321 |
$279K |
| K0004 |
High strength ltwt whlchr |
3,280 |
3,025 |
$154K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,790 |
3,398 |
$150K |
| E0247 |
Trans bench w/wo comm open |
2,008 |
1,789 |
$118K |
| T4541 |
Large disposable underpad |
3,697 |
3,455 |
$114K |
| K0003 |
Lightweight wheelchair |
1,161 |
1,074 |
$59K |
| E0143 |
Walker folding wheeled w/o s |
1,918 |
1,722 |
$51K |
| E0245 |
Tub stool or bench |
1,225 |
1,161 |
$42K |
| T4535 |
Disposable liner/shield/pad |
942 |
888 |
$38K |
| A4927 |
Non-sterile gloves |
2,173 |
2,018 |
$28K |
| T4523 |
Adult size brief/diaper lg |
195 |
180 |
$22K |
| E0244 |
Toilet seat raised |
447 |
422 |
$17K |
| E0973 |
W/ch access det adj armrest |
324 |
252 |
$16K |
| T4522 |
Adult size brief/diaper med |
192 |
177 |
$15K |
| E0303 |
Hosp bed hvy dty xtra wide |
143 |
127 |
$15K |
| E0630 |
Patient lift hydraulic |
323 |
262 |
$13K |
| E0163 |
Commode chair with fixed arm |
503 |
453 |
$13K |
| A4670 |
Automatic bp monitor, dial |
318 |
299 |
$12K |
| E2611 |
Gen use back cush wdth <22in |
122 |
112 |
$11K |
| E0243 |
Toilet rail |
358 |
316 |
$11K |
| E0156 |
Walker seat attachment |
1,367 |
1,211 |
$9K |
| E0627 |
Seat lift mech, electric any |
780 |
699 |
$9K |
| E1031 |
Rollabout chair with casters |
343 |
322 |
$6K |
| E0971 |
Wheelchair anti-tipping devi |
221 |
181 |
$6K |
| E0651 |
Pneum compressor segmental |
77 |
71 |
$6K |
| E0149 |
Heavy duty wheeled walker |
413 |
376 |
$5K |
| E0185 |
Gel pressure mattress pad |
136 |
121 |
$5K |
| E0248 |
Hdtrans bench w/wo comm open |
67 |
56 |
$4K |
| E2601 |
Gen w/c cushion wdth < 22 in |
183 |
167 |
$4K |
| E0570 |
Nebulizer with compression |
333 |
322 |
$4K |
| E1038 |
Transport chair pt wt<=300lb |
155 |
144 |
$4K |
| E0250 |
Hosp bed fixed ht w/ mattres |
219 |
218 |
$3K |
| E0159 |
Brake for wheeled walker |
267 |
233 |
$3K |
| E0978 |
W/c acc,saf belt pelv strap |
179 |
165 |
$2K |
| E0165 |
Commode chair with detacharm |
135 |
121 |
$2K |
| E0240 |
Bath/shower chair |
15 |
14 |
$2K |
| T4524 |
Adult size brief/diaper xl |
13 |
13 |
$1K |
| E0951 |
Loop heel |
133 |
106 |
$1K |
| K0739 |
Repair/svc dme non-oxygen eq |
137 |
124 |
$1K |
| E0246 |
Transfer tub rail attachment |
28 |
26 |
$1K |
| E0241 |
Bath tub wall rail |
28 |
27 |
$537.39 |
| A9286 |
Any hygienic item, device |
46 |
41 |
$0.00 |
| A9270 |
Non-covered item or service |
139 |
125 |
$0.00 |