| Code | Description | Claims | Beneficiaries | Total Paid |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
18,168 |
10,729 |
$1.30M |
| A4554 |
Disposable underpads, all sizes |
23,272 |
23,178 |
$876K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12,992 |
12,941 |
$867K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
8,932 |
8,907 |
$789K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
16,700 |
16,642 |
$589K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
1,910 |
1,067 |
$509K |
| L3215 |
Orthopedic footwear, ladies shoe, oxford, each |
4,514 |
2,589 |
$359K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
6,533 |
3,974 |
$320K |
| L3219 |
Orthopedic footwear, mens shoe, oxford, each |
3,318 |
1,890 |
$304K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
13,563 |
13,510 |
$297K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
4,521 |
2,664 |
$252K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
8,541 |
8,516 |
$252K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,084 |
2,076 |
$239K |
| L3222 |
Orthopedic footwear, mens shoe, hightop, depth inlay, each |
585 |
297 |
$54K |
| E0570 |
Nebulizer, with compressor |
585 |
585 |
$53K |
| L3217 |
Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
555 |
298 |
$45K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
727 |
363 |
$38K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
1,257 |
758 |
$31K |
| L3410 |
Metatarsal bar wedge, between sole |
383 |
202 |
$25K |
| L3002 |
Foot, insert, removable, molded to patient model, plastazote or equal, each |
221 |
110 |
$24K |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
498 |
496 |
$22K |
| A4927 |
Gloves, non-sterile, per 100 |
4,154 |
4,137 |
$19K |
| L3050 |
Foot, arch support, removable, premolded, metatarsal, each |
449 |
222 |
$18K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
141 |
68 |
$16K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
802 |
801 |
$13K |
| L3485 |
Heel, pad, removable for spur |
141 |
75 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
363 |
363 |
$5K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
30 |
30 |
$3K |
| A5120 |
Skin barrier, wipes or swabs, each |
93 |
93 |
$1K |
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
14 |
13 |
$602.56 |