| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
123,063 |
122,839 |
$8.35M |
| A4554 |
Disposable underpads |
231,856 |
231,456 |
$8.30M |
| T4522 |
Adult size brief/diaper med |
125,719 |
125,499 |
$6.13M |
| T4535 |
Disposable liner/shield/pad |
135,807 |
135,615 |
$4.22M |
| T4524 |
Adult size brief/diaper xl |
54,338 |
54,223 |
$4.06M |
| T4543 |
Adult disp brief/diap abv xl |
15,662 |
15,625 |
$2.12M |
| T4537 |
Reusable underpad bed size |
53,713 |
53,608 |
$1.26M |
| T4521 |
Adult size brief/diaper sm |
16,682 |
16,650 |
$740K |
| B4154 |
Ef spec metabolic noninherit |
5,951 |
5,922 |
$612K |
| A4335 |
Incontinence supply |
13,402 |
13,334 |
$549K |
| B4150 |
Ef complet w/intact nutrient |
7,137 |
7,107 |
$482K |
| E1399 |
Durable medical equipment mi |
3,910 |
3,838 |
$328K |
| A4927 |
Non-sterile gloves |
73,672 |
73,475 |
$278K |
| B9998 |
Enteral supp not otherwise c |
1,215 |
1,196 |
$273K |
| T4539 |
Reuse diaper/brief any size |
11,485 |
11,467 |
$239K |
| E0240 |
Bath/shower chair |
7,487 |
7,470 |
$211K |
| T4540 |
Reusable underpad chair size |
13,342 |
13,302 |
$204K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,267 |
2,253 |
$180K |
| A4253 |
Blood glucose/reagent strips |
10,123 |
10,097 |
$177K |
| A4670 |
Automatic bp monitor, dial |
4,464 |
4,453 |
$175K |
| E0143 |
Walker folding wheeled w/o s |
2,834 |
2,821 |
$138K |
| K0001 |
Standard wheelchair |
7,648 |
7,608 |
$133K |
| E0371 |
Nonpower mattress overlay |
397 |
397 |
$108K |
| E1390 |
Oxygen concentrator |
1,927 |
1,904 |
$96K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,969 |
1,955 |
$93K |
| T4533 |
Youth size brief/diaper |
998 |
992 |
$87K |
| A4649 |
Surgical supplies |
776 |
743 |
$71K |
| E0163 |
Commode chair with fixed arm |
996 |
995 |
$50K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,504 |
2,489 |
$38K |
| E0241 |
Bath tub wall rail |
1,102 |
1,099 |
$33K |
| A4259 |
Lancets per box |
9,460 |
9,447 |
$32K |
| E0156 |
Walker seat attachment |
2,302 |
2,294 |
$28K |
| E0630 |
Patient lift hydraulic |
1,134 |
1,129 |
$27K |
| A4402 |
Lubricant per ounce |
4,969 |
4,927 |
$25K |
| E0244 |
Toilet seat raised |
1,464 |
1,460 |
$23K |
| A5120 |
Skin barrier, wipe or swab |
1,290 |
1,275 |
$21K |
| E0990 |
Wheelchair elevating leg res |
1,096 |
1,086 |
$20K |
| B4100 |
Food thickener oral |
828 |
819 |
$18K |
| E0431 |
Portable gaseous 02 |
1,544 |
1,520 |
$17K |
| A6250 |
Skin seal protect moisturizr |
1,193 |
1,168 |
$17K |
| E0100 |
Cane adjust/fixed with tip |
1,821 |
1,819 |
$15K |
| E0243 |
Toilet rail |
253 |
252 |
$13K |
| E0607 |
Blood glucose monitor home |
571 |
571 |
$11K |
| A4216 |
Sterile water/saline, 10 ml |
270 |
263 |
$9K |
| A4245 |
Alcohol wipes per box |
7,613 |
7,604 |
$9K |
| E0185 |
Gel pressure mattress pad |
207 |
201 |
$9K |
| A6262 |
Wound filler dry form / gram |
18 |
17 |
$9K |
| E0247 |
Trans bench w/wo comm open |
138 |
138 |
$9K |
| A6402 |
Sterile gauze <= 16 sq in |
513 |
494 |
$8K |
| E0245 |
Tub stool or bench |
401 |
400 |
$8K |
| E0184 |
Dry pressure mattress |
68 |
68 |
$8K |
| K0195 |
Elevating whlchair leg rests |
2,874 |
2,861 |
$8K |
| E0277 |
Powered pres-redu air mattrs |
75 |
75 |
$7K |
| K0739 |
Repair/svc dme non-oxygen eq |
141 |
139 |
$7K |
| E0978 |
W/c acc,saf belt pelv strap |
359 |
356 |
$5K |
| E2603 |
Skin protect wc cus wd <22in |
49 |
48 |
$4K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
43 |
43 |
$4K |
| E0570 |
Nebulizer with compression |
100 |
100 |
$4K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
42 |
41 |
$4K |
| A6216 |
Non-sterile gauze<=16 sq in |
245 |
237 |
$3K |
| E0105 |
Cane adjust/fixed quad/3 pro |
252 |
251 |
$3K |
| E0971 |
Wheelchair anti-tipping devi |
122 |
112 |
$3K |
| E0114 |
Crutch underarm pair no wood |
194 |
194 |
$3K |
| E0246 |
Transfer tub rail attachment |
67 |
67 |
$2K |
| A4357 |
Bedside drainage bag |
39 |
39 |
$2K |
| A9999 |
Dme supply or accessory, nos |
12 |
12 |
$2K |
| L3670 |
So acro/clav can web pre ots |
35 |
30 |
$2K |
| E2611 |
Gen use back cush wdth <22in |
43 |
43 |
$2K |
| A9900 |
Supply/accessory/service |
51 |
51 |
$2K |
| A6212 |
Foam drg <=16 sq in w/border |
13 |
13 |
$1K |
| A6258 |
Transparent film >16<=48 in |
35 |
34 |
$1K |
| E0973 |
W/ch access det adj armrest |
13 |
13 |
$1K |
| A6197 |
Alginate drsg >16 <=48 sq in |
14 |
13 |
$1K |
| E0271 |
Mattress innerspring |
12 |
12 |
$944.84 |
| A4258 |
Lancet device each |
89 |
89 |
$775.89 |
| E2601 |
Gen w/c cushion wdth < 22 in |
52 |
52 |
$626.26 |
| L1830 |
Ko immob canvas long pre ots |
13 |
13 |
$439.26 |
| E0215 |
Electric heat pad moist |
26 |
26 |
$369.98 |
| A6446 |
Conform band s w>=3" <5"/yd |
32 |
30 |
$282.82 |
| A4450 |
Non-waterproof tape |
55 |
53 |
$242.08 |
| E0325 |
Urinal male jug-type |
12 |
12 |
$24.37 |