| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
12,110 |
10,546 |
$2.10M |
| A4554 |
Disposable underpads |
24,911 |
21,061 |
$1.32M |
| T4535 |
Disposable liner/shield/pad |
16,353 |
14,036 |
$979K |
| A4927 |
Non-sterile gloves |
28,773 |
24,549 |
$749K |
| A6250 |
Skin seal protect moisturizr |
24,571 |
20,474 |
$731K |
| T4526 |
Adult size pull-on med |
4,738 |
3,831 |
$624K |
| T4528 |
Adult size pull-on xl |
3,121 |
2,476 |
$499K |
| E0221 |
Infrared heating pad system |
209 |
122 |
$431K |
| B4150 |
Ef complet w/intact nutrient |
3,348 |
2,530 |
$317K |
| B4154 |
Ef spec metabolic noninherit |
1,082 |
910 |
$243K |
| T4523 |
Adult size brief/diaper lg |
1,485 |
1,104 |
$177K |
| T4544 |
Adlt disp und/pull on abv xl |
699 |
623 |
$168K |
| L0650 |
Lso sc r ant/pos pnl pre ots |
248 |
205 |
$133K |
| E0172 |
Seat lift mechanism toilet |
68 |
44 |
$103K |
| E1399 |
Durable medical equipment mi |
143 |
115 |
$93K |
| A9900 |
Supply/accessory/service |
589 |
469 |
$89K |
| K0739 |
Repair/svc dme non-oxygen eq |
612 |
329 |
$76K |
| E0190 |
Positioning cushion |
392 |
88 |
$75K |
| T4522 |
Adult size brief/diaper med |
591 |
492 |
$60K |
| T4534 |
Youth size pull-on |
349 |
282 |
$59K |
| A6530 |
Compression stocking bk18-30 |
1,450 |
1,345 |
$57K |
| K0001 |
Standard wheelchair |
1,309 |
990 |
$56K |
| E0245 |
Tub stool or bench |
1,206 |
774 |
$44K |
| E0135 |
Walker folding adjust/fixed |
1,216 |
912 |
$41K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,434 |
1,159 |
$40K |
| A4215 |
Sterile needle |
1,338 |
1,189 |
$39K |
| B4152 |
Ef calorie dense>/=1.5kcal |
254 |
185 |
$34K |
| E0143 |
Walker folding wheeled w/o s |
1,263 |
955 |
$34K |
| A4253 |
Blood glucose/reagent strips |
2,786 |
2,425 |
$24K |
| L1833 |
Ko adj jnt pos r sup pre ots |
91 |
26 |
$20K |
| E1390 |
Oxygen concentrator |
372 |
276 |
$19K |
| E0202 |
Phototherapy light w/ photom |
101 |
38 |
$19K |
| T4543 |
Adult disp brief/diap abv xl |
80 |
74 |
$17K |
| A4239 |
Non-adju cgm supply allow |
175 |
167 |
$17K |
| A4245 |
Alcohol wipes per box |
3,213 |
2,867 |
$16K |
| E0240 |
Bath/shower chair |
55 |
52 |
$15K |
| A4670 |
Automatic bp monitor, dial |
202 |
154 |
$13K |
| T4524 |
Adult size brief/diaper xl |
110 |
102 |
$12K |
| K0108 |
W/c component-accessory nos |
19 |
17 |
$12K |
| E0156 |
Walker seat attachment |
1,100 |
712 |
$10K |
| E0114 |
Crutch underarm pair no wood |
197 |
155 |
$8K |
| E0570 |
Nebulizer with compression |
266 |
179 |
$7K |
| E0630 |
Patient lift hydraulic |
303 |
249 |
$6K |
| K0195 |
Elevating whlchair leg rests |
653 |
481 |
$6K |
| A6533 |
Gc stocking thighlngth 18-30 |
109 |
98 |
$6K |
| A4259 |
Lancets per box |
2,734 |
2,413 |
$5K |
| E0277 |
Powered pres-redu air mattrs |
25 |
12 |
$4K |
| K0002 |
Stnd hemi (low seat) whlchr |
36 |
28 |
$4K |
| S5161 |
Emer rspns sys serv permonth |
39 |
36 |
$3K |
| K0823 |
Pwc gp 2 std cap chair |
13 |
12 |
$3K |
| E0973 |
W/ch access det adj armrest |
24 |
14 |
$2K |
| L2397 |
Suspension sleeve lower ext |
63 |
14 |
$2K |
| A4452 |
Waterproof tape |
46 |
37 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
14 |
12 |
$980.00 |
| E0971 |
Wheelchair anti-tipping devi |
21 |
12 |
$523.20 |
| E0431 |
Portable gaseous 02 |
57 |
24 |
$361.88 |
| E0978 |
W/c acc,saf belt pelv strap |
13 |
12 |
$359.16 |
| A4258 |
Lancet device each |
125 |
124 |
$357.86 |
| E0163 |
Commode chair with fixed arm |
18 |
12 |
$312.27 |
| A6260 |
Wound cleanser any type/size |
13 |
13 |
$174.88 |