| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
286,714 |
285,574 |
$15.04M |
| A4554 |
Disposable underpads |
538,206 |
536,270 |
$14.70M |
| T4535 |
Disposable liner/shield/pad |
584,838 |
583,144 |
$11.76M |
| T4522 |
Adult size brief/diaper med |
326,290 |
325,285 |
$11.69M |
| T4524 |
Adult size brief/diaper xl |
120,910 |
120,357 |
$7.08M |
| T4543 |
Adult disp brief/diap abv xl |
32,670 |
32,447 |
$3.88M |
| L3000 |
Ft insert ucb berkeley shell |
23,169 |
12,177 |
$3.46M |
| E0241 |
Bath tub wall rail |
31,485 |
31,372 |
$3.21M |
| T4537 |
Reusable underpad bed size |
92,325 |
92,019 |
$2.91M |
| A4927 |
Non-sterile gloves |
540,957 |
539,442 |
$2.36M |
| T4521 |
Adult size brief/diaper sm |
48,419 |
48,267 |
$1.46M |
| L2275 |
Plastic mod low ext pad/line |
22,814 |
11,948 |
$1.42M |
| A4253 |
Blood glucose/reagent strips |
63,642 |
63,330 |
$948K |
| T4539 |
Reuse diaper/brief any size |
28,974 |
28,841 |
$756K |
| E0240 |
Bath/shower chair |
11,905 |
11,852 |
$410K |
| A4670 |
Automatic bp monitor, dial |
8,620 |
8,501 |
$406K |
| L3216 |
Orthoped ladies shoes dpth i |
7,877 |
3,981 |
$346K |
| A4259 |
Lancets per box |
61,321 |
61,074 |
$334K |
| T4540 |
Reusable underpad chair size |
20,202 |
20,130 |
$327K |
| K0001 |
Standard wheelchair |
39,876 |
38,621 |
$314K |
| L3221 |
Orthopedic mens shoes dpth i |
6,594 |
3,314 |
$308K |
| L3410 |
Shoe metatarsal bar between |
7,198 |
3,603 |
$304K |
| E0143 |
Walker folding wheeled w/o s |
8,051 |
7,825 |
$254K |
| B4150 |
Ef complet w/intact nutrient |
3,049 |
3,020 |
$226K |
| E0247 |
Trans bench w/wo comm open |
2,769 |
2,750 |
$215K |
| E2611 |
Gen use back cush wdth <22in |
3,969 |
3,730 |
$184K |
| B4154 |
Ef spec metabolic noninherit |
1,261 |
1,245 |
$165K |
| E1390 |
Oxygen concentrator |
5,754 |
5,623 |
$163K |
| E0260 |
Hosp bed semi-electr w/ matt |
15,074 |
14,637 |
$160K |
| L3215 |
Orthopedic ftwear ladies oxf |
3,130 |
1,748 |
$126K |
| E0630 |
Patient lift hydraulic |
5,133 |
4,969 |
$115K |
| L3219 |
Orthopedic mens shoes oxford |
2,260 |
1,265 |
$103K |
| E0163 |
Commode chair with fixed arm |
3,623 |
3,451 |
$85K |
| A4245 |
Alcohol wipes per box |
58,891 |
58,703 |
$83K |
| E0261 |
Hosp bed semi-electr w/o mat |
3,293 |
3,247 |
$78K |
| E1399 |
Durable medical equipment mi |
6,395 |
6,249 |
$72K |
| A6537 |
Gc stocking full lngth 30-40 |
132 |
121 |
$71K |
| E0971 |
Wheelchair anti-tipping devi |
7,731 |
4,367 |
$70K |
| E0244 |
Toilet seat raised |
3,661 |
3,647 |
$69K |
| A4335 |
Incontinence supply |
6,805 |
6,715 |
$67K |
| A6533 |
Gc stocking thighlngth 18-30 |
1,765 |
1,705 |
$66K |
| B4152 |
Ef calorie dense>/=1.5kcal |
800 |
790 |
$66K |
| E0990 |
Wheelchair elevating leg res |
5,644 |
5,539 |
$58K |
| L3202 |
Oxford w/ supinat/pronator c |
2,581 |
1,445 |
$56K |
| A6530 |
Compression stocking bk18-30 |
1,562 |
1,542 |
$53K |
| E0156 |
Walker seat attachment |
5,365 |
5,236 |
$53K |
| A6539 |
Gc stocking waistlngth 18-30 |
376 |
340 |
$52K |
| E2601 |
Gen w/c cushion wdth < 22 in |
4,987 |
4,697 |
$48K |
| K0195 |
Elevating whlchair leg rests |
29,307 |
28,390 |
$47K |
| K0003 |
Lightweight wheelchair |
4,155 |
3,914 |
$42K |
| A6540 |
Gc stocking waistlngth 30-40 |
122 |
121 |
$41K |
| E0274 |
Over-bed table |
426 |
425 |
$37K |
| K0006 |
Heavy duty wheelchair |
1,601 |
1,555 |
$37K |
| E0243 |
Toilet rail |
261 |
261 |
$34K |
| E0277 |
Powered pres-redu air mattrs |
447 |
411 |
$34K |
| E1226 |
Manual fully reclining back |
424 |
391 |
$34K |
| E0185 |
Gel pressure mattress pad |
1,242 |
1,146 |
$31K |
| K0007 |
Extra heavy duty wheelchair |
776 |
748 |
$31K |
| E0431 |
Portable gaseous 02 |
4,328 |
4,199 |
$27K |
| E0961 |
Wheelchair brake extension |
6,436 |
3,636 |
$26K |
| E1392 |
Portable oxygen concentrator |
1,453 |
1,392 |
$24K |
| E0978 |
W/c acc,saf belt pelv strap |
4,073 |
3,854 |
$22K |
| E0570 |
Nebulizer with compression |
2,461 |
2,429 |
$21K |
| E0149 |
Heavy duty wheeled walker |
1,247 |
1,214 |
$20K |
| A5513 |
Multi den insert custom mold |
385 |
331 |
$17K |
| A5500 |
Diab shoe for density insert |
404 |
345 |
$16K |
| K0004 |
High strength ltwt whlchr |
1,121 |
1,061 |
$15K |
| A4239 |
Non-adju cgm supply allow |
139 |
134 |
$14K |
| L3480 |
Shoe heel pad & depress for |
486 |
247 |
$14K |
| E0100 |
Cane adjust/fixed with tip |
1,938 |
1,905 |
$14K |
| E0635 |
Patient lift electric |
1,019 |
974 |
$12K |
| E0246 |
Transfer tub rail attachment |
83 |
83 |
$8K |
| E0303 |
Hosp bed hvy dty xtra wide |
400 |
379 |
$8K |
| A9901 |
Delivery/set up/dispensing |
170 |
169 |
$5K |
| E0245 |
Tub stool or bench |
205 |
205 |
$5K |
| K0739 |
Repair/svc dme non-oxygen eq |
115 |
114 |
$5K |
| E0955 |
Cushioned headrest |
1,311 |
1,240 |
$5K |
| E1038 |
Transport chair pt wt<=300lb |
2,569 |
2,461 |
$5K |
| E0272 |
Mattress foam rubber |
273 |
268 |
$4K |
| B4100 |
Food thickener oral |
83 |
82 |
$4K |
| A6250 |
Skin seal protect moisturizr |
291 |
289 |
$4K |
| E0265 |
Hosp bed total electr w/ mat |
372 |
354 |
$4K |
| E0181 |
Press pad alternating w/ pum |
918 |
890 |
$4K |
| K0002 |
Stnd hemi (low seat) whlchr |
469 |
394 |
$4K |
| E0105 |
Cane adjust/fixed quad/3 pro |
292 |
279 |
$3K |
| E0973 |
W/ch access det adj armrest |
222 |
200 |
$3K |
| E2612 |
Gen use back cush wdth>=22in |
48 |
36 |
$3K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
58 |
58 |
$3K |
| E0165 |
Commode chair with detacharm |
330 |
313 |
$2K |
| E0621 |
Patient lift sling or seat |
98 |
92 |
$2K |
| E2602 |
Gen w/c cushion wdth >=22 in |
58 |
51 |
$1K |
| A6534 |
Gc stocking thighlngth 30-40 |
26 |
26 |
$1K |
| A4402 |
Lubricant per ounce |
690 |
682 |
$1K |
| L3334 |
Shoe lifts elevation heel /i |
31 |
31 |
$1K |
| A4258 |
Lancet device each |
214 |
212 |
$1K |
| E0910 |
Trapeze bar attached to bed |
289 |
284 |
$787.64 |
| E1031 |
Rollabout chair with casters |
200 |
173 |
$697.59 |
| L3320 |
Shoe lift elev heel/sole cor |
12 |
12 |
$548.16 |
| E0607 |
Blood glucose monitor home |
17 |
17 |
$363.28 |
| A7005 |
Nondisposable nebulizer set |
31 |
31 |
$176.97 |
| E0325 |
Urinal male jug-type |
56 |
55 |
$145.41 |
| A6531 |
Compress stking bk30-40 surg |
12 |
12 |
$134.17 |
| A7015 |
Aerosol mask used w nebulize |
31 |
31 |
$9.10 |