| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
34,609 |
33,338 |
$1.18M |
| T4527 |
Adult size pull-on lg |
8,765 |
8,429 |
$884K |
| T4526 |
Adult size pull-on med |
9,105 |
8,722 |
$859K |
| B4150 |
Ef complet w/intact nutrient |
8,342 |
7,415 |
$761K |
| T4528 |
Adult size pull-on xl |
6,742 |
6,498 |
$747K |
| A4927 |
Non-sterile gloves |
46,802 |
45,100 |
$670K |
| T4543 |
Adult disp brief/diap abv xl |
2,654 |
2,529 |
$644K |
| B4154 |
Ef spec metabolic noninherit |
4,665 |
4,152 |
$633K |
| T4535 |
Disposable liner/shield/pad |
12,975 |
12,412 |
$492K |
| T4537 |
Reusable underpad bed size |
4,882 |
4,687 |
$464K |
| T4544 |
Adlt disp und/pull on abv xl |
2,193 |
2,081 |
$418K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,571 |
3,095 |
$416K |
| T4524 |
Adult size brief/diaper xl |
2,652 |
2,546 |
$305K |
| T4525 |
Adult size pull-on sm |
3,153 |
3,028 |
$294K |
| T4523 |
Adult size brief/diaper lg |
2,655 |
2,494 |
$273K |
| T4522 |
Adult size brief/diaper med |
2,117 |
1,959 |
$206K |
| T4540 |
Reusable underpad chair size |
4,115 |
3,940 |
$195K |
| E0144 |
Enclosed walker w rear seat |
1,609 |
1,507 |
$165K |
| E0570 |
Nebulizer with compression |
1,707 |
1,620 |
$133K |
| A4670 |
Automatic bp monitor, dial |
4,011 |
3,840 |
$131K |
| E0730 |
Tens four lead |
1,822 |
1,762 |
$125K |
| A4351 |
Straight tip urine catheter |
1,803 |
1,729 |
$122K |
| A4595 |
Tens suppl 2 lead per month |
5,931 |
5,885 |
$102K |
| A6530 |
Compression stocking bk18-30 |
2,218 |
1,924 |
$97K |
| L3908 |
Who cock-up nonmolde pre ots |
1,617 |
1,328 |
$44K |
| E0245 |
Tub stool or bench |
1,414 |
1,364 |
$43K |
| A5061 |
Pouch drainable w barrier at |
887 |
842 |
$35K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
247 |
193 |
$26K |
| A5500 |
Diab shoe for density insert |
890 |
519 |
$21K |
| A4349 |
Disposable male external cat |
489 |
451 |
$17K |
| A4357 |
Bedside drainage bag |
1,945 |
1,856 |
$15K |
| L1810 |
Ko elastic with joints |
295 |
272 |
$13K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
215 |
208 |
$11K |
| T4532 |
Ped size pull-on lg |
150 |
146 |
$11K |
| A6402 |
Sterile gauze <= 16 sq in |
1,094 |
1,013 |
$10K |
| T4521 |
Adult size brief/diaper sm |
89 |
83 |
$9K |
| A6533 |
Gc stocking thighlngth 18-30 |
165 |
133 |
$8K |
| A4358 |
Urinary leg or abdomen bag |
918 |
841 |
$6K |
| A4450 |
Non-waterproof tape |
838 |
806 |
$6K |
| E0100 |
Cane adjust/fixed with tip |
765 |
739 |
$5K |
| A6446 |
Conform band s w>=3" <5"/yd |
200 |
191 |
$5K |
| A4253 |
Blood glucose/reagent strips |
1,330 |
1,197 |
$4K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
76 |
76 |
$4K |
| A4338 |
Indwelling catheter latex |
641 |
552 |
$3K |
| A4310 |
Insert tray w/o bag/cath |
679 |
599 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
152 |
145 |
$3K |
| T4531 |
Ped size pull-on sm/med |
25 |
25 |
$3K |
| A5512 |
Multi den insert direct form |
242 |
138 |
$3K |
| L0628 |
Lso flex no ri stays pre ots |
55 |
53 |
$2K |
| A5513 |
Multi den insert custom mold |
129 |
80 |
$2K |
| A5514 |
Mult den insert dir carv/cam |
81 |
41 |
$2K |
| E0105 |
Cane adjust/fixed quad/3 pro |
56 |
54 |
$1K |
| A4402 |
Lubricant per ounce |
500 |
472 |
$1K |
| T4534 |
Youth size pull-on |
12 |
12 |
$1K |
| E0244 |
Toilet seat raised |
24 |
24 |
$911.10 |
| A5120 |
Skin barrier, wipe or swab |
176 |
169 |
$838.62 |
| L0630 |
Lso r post pnl sj-t9 pre cst |
12 |
12 |
$587.40 |
| A5063 |
Drain ostomy pouch w/flange |
36 |
36 |
$476.17 |
| A4405 |
Nonpectin based ostomy paste |
53 |
52 |
$399.63 |
| E0156 |
Walker seat attachment |
78 |
75 |
$363.83 |
| A4467 |
Belt strap sleev grmnt cover |
16 |
14 |
$363.60 |
| E0163 |
Commode chair with fixed arm |
12 |
12 |
$363.28 |
| A7003 |
Nebulizer administration set |
85 |
84 |
$138.11 |
| A4259 |
Lancets per box |
189 |
172 |
$61.98 |
| A4331 |
Extension drainage tubing |
12 |
12 |
$61.90 |