| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment mi |
2,975 |
2,530 |
$1.57M |
| A4554 |
Disposable underpads |
36,925 |
36,690 |
$1.30M |
| T4527 |
Adult size pull-on lg |
10,691 |
10,574 |
$1.11M |
| B4154 |
Ef spec metabolic noninherit |
1,698 |
1,630 |
$803K |
| T4528 |
Adult size pull-on xl |
5,768 |
5,689 |
$779K |
| T4535 |
Disposable liner/shield/pad |
23,955 |
22,720 |
$773K |
| T4526 |
Adult size pull-on med |
8,983 |
8,931 |
$757K |
| B4150 |
Ef complet w/intact nutrient |
2,420 |
2,379 |
$433K |
| T4544 |
Adlt disp und/pull on abv xl |
1,693 |
1,647 |
$357K |
| A4335 |
Incontinence supply |
42,930 |
42,502 |
$244K |
| E0240 |
Bath/shower chair |
681 |
665 |
$151K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,182 |
3,144 |
$129K |
| T4525 |
Adult size pull-on sm |
1,764 |
1,753 |
$128K |
| T4523 |
Adult size brief/diaper lg |
1,084 |
1,075 |
$96K |
| K0003 |
Lightweight wheelchair |
3,096 |
3,054 |
$90K |
| T4524 |
Adult size brief/diaper xl |
673 |
672 |
$86K |
| T4522 |
Adult size brief/diaper med |
774 |
768 |
$69K |
| A4253 |
Blood glucose/reagent strips |
2,346 |
2,244 |
$59K |
| T4537 |
Reusable underpad bed size |
381 |
370 |
$49K |
| A6533 |
Gc stocking thighlngth 18-30 |
158 |
80 |
$43K |
| A4670 |
Automatic bp monitor, dial |
686 |
684 |
$40K |
| A4927 |
Non-sterile gloves |
3,226 |
3,181 |
$24K |
| E0630 |
Patient lift hydraulic |
584 |
568 |
$21K |
| K0195 |
Elevating whlchair leg rests |
2,355 |
2,301 |
$18K |
| E0627 |
Seat lift mech, electric any |
145 |
139 |
$12K |
| E0910 |
Trapeze bar attached to bed |
1,725 |
1,705 |
$11K |
| A4259 |
Lancets per box |
2,064 |
2,047 |
$11K |
| E0143 |
Walker folding wheeled w/o s |
267 |
263 |
$10K |
| B4034 |
Enter feed supkit syr by day |
206 |
189 |
$8K |
| E0570 |
Nebulizer with compression |
563 |
563 |
$5K |
| A4245 |
Alcohol wipes per box |
1,222 |
1,212 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
99 |
58 |
$1K |
| E2611 |
Gen use back cush wdth <22in |
44 |
43 |
$967.67 |
| E2601 |
Gen w/c cushion wdth < 22 in |
57 |
56 |
$940.84 |
| E0185 |
Gel pressure mattress pad |
12 |
12 |
$776.35 |
| E0156 |
Walker seat attachment |
268 |
262 |
$662.73 |
| A7003 |
Nebulizer administration set |
39 |
39 |
$40.81 |
| A4256 |
Calibrator solution/chips |
14 |
13 |
$25.83 |
| A7015 |
Aerosol mask used w nebulize |
40 |
40 |
$25.43 |
| A4258 |
Lancet device each |
18 |
17 |
$17.88 |
| A5514 |
Mult den insert dir carv/cam |
14 |
14 |
$0.00 |
| A5500 |
Diab shoe for density insert |
32 |
32 |
$0.00 |
| E0607 |
Blood glucose monitor home |
18 |
17 |
$0.00 |