| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
2,861 |
2,659 |
$215K |
| L4361 |
Pneuma/vac walk boot pre ots |
1,219 |
1,065 |
$182K |
| E0114 |
Crutch underarm pair no wood |
5,768 |
5,023 |
$170K |
| T4535 |
Disposable liner/shield/pad |
2,210 |
2,050 |
$154K |
| T4527 |
Adult size pull-on lg |
958 |
908 |
$139K |
| L4350 |
Ankle control ortho pre ots |
2,386 |
2,146 |
$130K |
| E0570 |
Nebulizer with compression |
3,553 |
2,803 |
$126K |
| T4526 |
Adult size pull-on med |
865 |
809 |
$126K |
| L3660 |
So 8 ab rstr can/web pre ots |
2,201 |
1,849 |
$125K |
| L3670 |
So acro/clav can web pre ots |
1,799 |
1,535 |
$109K |
| L1830 |
Ko immob canvas long pre ots |
2,170 |
1,852 |
$103K |
| E0143 |
Walker folding wheeled w/o s |
5,808 |
4,223 |
$101K |
| L3809 |
Whfo w/o joints pre ots |
829 |
724 |
$95K |
| L3908 |
Who cock-up nonmolde pre ots |
2,149 |
1,799 |
$79K |
| T4528 |
Adult size pull-on xl |
503 |
479 |
$72K |
| A4927 |
Non-sterile gloves |
2,899 |
2,716 |
$64K |
| T4523 |
Adult size brief/diaper lg |
431 |
403 |
$55K |
| L4360 |
Pneumat walking boot pre cst |
330 |
285 |
$53K |
| T4524 |
Adult size brief/diaper xl |
391 |
371 |
$50K |
| T4544 |
Adlt disp und/pull on abv xl |
205 |
197 |
$49K |
| E0247 |
Trans bench w/wo comm open |
340 |
280 |
$39K |
| T4522 |
Adult size brief/diaper med |
414 |
378 |
$37K |
| A7005 |
Nondisposable nebulizer set |
2,343 |
2,095 |
$36K |
| T4543 |
Adult disp brief/diap abv xl |
119 |
115 |
$30K |
| L3807 |
Whfo w/o joints pre cst |
218 |
193 |
$26K |
| L3260 |
Ambulatory surgical boot eac |
2,378 |
1,863 |
$26K |
| E0245 |
Tub stool or bench |
358 |
310 |
$23K |
| E2611 |
Gen use back cush wdth <22in |
198 |
181 |
$21K |
| E0100 |
Cane adjust/fixed with tip |
1,897 |
1,463 |
$19K |
| E0241 |
Bath tub wall rail |
204 |
158 |
$12K |
| K0001 |
Standard wheelchair |
1,547 |
1,413 |
$10K |
| E0260 |
Hosp bed semi-electr w/ matt |
676 |
585 |
$10K |
| A9281 |
Reaching/grabbing device |
166 |
143 |
$8K |
| E0163 |
Commode chair with fixed arm |
356 |
317 |
$7K |
| K0195 |
Elevating whlchair leg rests |
1,350 |
1,284 |
$6K |
| E0244 |
Toilet seat raised |
152 |
110 |
$6K |
| E2601 |
Gen w/c cushion wdth < 22 in |
187 |
170 |
$4K |
| A7015 |
Aerosol mask used w nebulize |
1,950 |
1,754 |
$3K |
| E0630 |
Patient lift hydraulic |
235 |
219 |
$3K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
136 |
127 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
41 |
38 |
$2K |
| T4525 |
Adult size pull-on sm |
12 |
12 |
$2K |
| E0242 |
Bath tub rail floor |
15 |
13 |
$1K |
| E0156 |
Walker seat attachment |
204 |
152 |
$1K |
| L1902 |
Afo ankle gauntlet pre ots |
13 |
13 |
$833.56 |
| L3650 |
So 8 abd restraint pre ots |
12 |
12 |
$547.32 |
| E0676 |
Inter limb compress dev nos |
114 |
111 |
$425.00 |
| K0006 |
Heavy duty wheelchair |
14 |
14 |
$288.58 |
| E0978 |
W/c acc,saf belt pelv strap |
76 |
64 |
$250.45 |