| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
153,028 |
142,150 |
$5.58M |
| B4154 |
Ef spec metabolic noninherit |
48,748 |
37,570 |
$4.97M |
| T4535 |
Disposable liner/shield/pad |
134,168 |
124,939 |
$4.92M |
| B4150 |
Ef complet w/intact nutrient |
67,977 |
50,598 |
$4.34M |
| T4527 |
Adult size pull-on lg |
61,283 |
56,475 |
$4.01M |
| T4544 |
Adlt disp und/pull on abv xl |
18,707 |
17,546 |
$3.29M |
| T4528 |
Adult size pull-on xl |
45,663 |
42,370 |
$3.28M |
| A4927 |
Non-sterile gloves |
213,054 |
197,918 |
$3.13M |
| T4526 |
Adult size pull-on med |
45,722 |
42,580 |
$2.72M |
| B4152 |
Ef calorie dense>/=1.5kcal |
30,339 |
22,043 |
$2.45M |
| T2029 |
Special med equip, noswaiver |
36,875 |
24,380 |
$2.30M |
| T4537 |
Reusable underpad bed size |
21,124 |
19,716 |
$2.15M |
| T4543 |
Adult disp brief/diap abv xl |
6,076 |
5,575 |
$1.12M |
| T4540 |
Reusable underpad chair size |
17,953 |
16,771 |
$910K |
| L4360 |
Pneumat walking boot pre cst |
5,817 |
5,367 |
$814K |
| T4523 |
Adult size brief/diaper lg |
8,360 |
7,431 |
$605K |
| T4524 |
Adult size brief/diaper xl |
6,939 |
6,169 |
$565K |
| T4522 |
Adult size brief/diaper med |
7,327 |
6,293 |
$518K |
| T4525 |
Adult size pull-on sm |
8,415 |
7,747 |
$454K |
| L3807 |
Whfo w/o joints pre cst |
2,886 |
2,688 |
$364K |
| T1999 |
Noc retail items andsupplies |
7,437 |
5,387 |
$351K |
| L4350 |
Ankle control ortho pre ots |
6,824 |
6,424 |
$332K |
| B4035 |
Enteral feed supp pump per d |
4,321 |
2,937 |
$332K |
| E0114 |
Crutch underarm pair no wood |
15,736 |
14,816 |
$294K |
| E0247 |
Trans bench w/wo comm open |
4,873 |
4,548 |
$274K |
| E0143 |
Walker folding wheeled w/o s |
11,587 |
10,399 |
$269K |
| A4670 |
Automatic bp monitor, dial |
6,544 |
6,122 |
$251K |
| L3650 |
So 8 abd restraint pre ots |
7,089 |
6,609 |
$249K |
| A4351 |
Straight tip urine catheter |
3,439 |
2,988 |
$236K |
| E0245 |
Tub stool or bench |
5,918 |
5,578 |
$185K |
| L3908 |
Who cock-up nonmolde pre ots |
5,401 |
4,702 |
$181K |
| L1830 |
Ko immob canvas long pre ots |
4,102 |
3,813 |
$164K |
| E0244 |
Toilet seat raised |
3,676 |
3,444 |
$148K |
| B9998 |
Enteral supp not otherwise c |
2,421 |
1,527 |
$127K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,111 |
729 |
$109K |
| B4034 |
Enter feed supkit syr by day |
2,939 |
2,240 |
$96K |
| A6530 |
Compression stocking bk18-30 |
1,751 |
1,193 |
$94K |
| E1390 |
Oxygen concentrator |
2,485 |
2,153 |
$89K |
| E0190 |
Positioning cushion |
1,100 |
1,019 |
$83K |
| L1820 |
Ko elas w/ condyle pads & jo |
1,113 |
1,034 |
$81K |
| E0163 |
Commode chair with fixed arm |
3,316 |
2,989 |
$76K |
| L3809 |
Whfo w/o joints pre ots |
944 |
853 |
$71K |
| A7030 |
Cpap full face mask |
1,564 |
1,417 |
$59K |
| E0627 |
Seat lift mech, electric any |
1,234 |
1,012 |
$47K |
| E0246 |
Transfer tub rail attachment |
1,018 |
971 |
$47K |
| B4155 |
Ef incomplete/modular |
1,174 |
769 |
$46K |
| A6196 |
Alginate dressing <=16 sq in |
279 |
251 |
$45K |
| E0149 |
Heavy duty wheeled walker |
3,517 |
3,072 |
$45K |
| E0260 |
Hosp bed semi-electr w/ matt |
324 |
255 |
$44K |
| E0156 |
Walker seat attachment |
7,377 |
6,608 |
$41K |
| L4361 |
Pneuma/vac walk boot pre ots |
785 |
687 |
$40K |
| E0241 |
Bath tub wall rail |
1,869 |
1,701 |
$38K |
| A6197 |
Alginate drsg >16 <=48 sq in |
93 |
86 |
$31K |
| L3660 |
So 8 ab rstr can/web pre ots |
1,912 |
1,569 |
$30K |
| A4349 |
Disposable male external cat |
1,169 |
947 |
$28K |
| E0243 |
Toilet rail |
880 |
828 |
$28K |
| A7034 |
Nasal application device |
1,193 |
1,088 |
$27K |
| A7035 |
Pos airway press headgear |
1,918 |
1,748 |
$27K |
| A7031 |
Replacement facemask interfa |
1,081 |
972 |
$25K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
317 |
272 |
$24K |
| A4570 |
Splint |
3,089 |
2,875 |
$24K |
| A7037 |
Pos airway pressure tubing |
2,547 |
2,320 |
$24K |
| A4629 |
Tracheostomy care kit |
1,003 |
794 |
$23K |
| E2611 |
Gen use back cush wdth <22in |
200 |
179 |
$20K |
| E0250 |
Hosp bed fixed ht w/ mattres |
1,275 |
1,132 |
$18K |
| K0003 |
Lightweight wheelchair |
574 |
458 |
$17K |
| E0630 |
Patient lift hydraulic |
510 |
401 |
$16K |
| E0165 |
Commode chair with detacharm |
2,195 |
1,946 |
$15K |
| A7526 |
Tracheostomy tube collar |
769 |
631 |
$14K |
| A4358 |
Urinary leg or abdomen bag |
3,192 |
2,358 |
$12K |
| A4314 |
Cath w/drainage 2-way latex |
1,756 |
1,550 |
$11K |
| E0601 |
Cont airway pressure device |
729 |
585 |
$10K |
| A4357 |
Bedside drainage bag |
3,512 |
3,010 |
$10K |
| A7039 |
Filter, non disposable w pap |
1,851 |
1,711 |
$10K |
| E0135 |
Walker folding adjust/fixed |
365 |
330 |
$10K |
| A7000 |
Disposable canister for pump |
1,245 |
986 |
$10K |
| A7005 |
Nondisposable nebulizer set |
1,315 |
1,171 |
$10K |
| A6212 |
Foam drg <=16 sq in w/border |
97 |
83 |
$10K |
| A7003 |
Nebulizer administration set |
5,248 |
4,055 |
$9K |
| A7038 |
Pos airway pressure filter |
3,006 |
2,640 |
$9K |
| E0105 |
Cane adjust/fixed quad/3 pro |
468 |
427 |
$9K |
| E0431 |
Portable gaseous 02 |
954 |
811 |
$9K |
| A6402 |
Sterile gauze <= 16 sq in |
1,926 |
1,642 |
$9K |
| E1392 |
Portable oxygen concentrator |
409 |
379 |
$9K |
| A7032 |
Replacement nasal cushion |
510 |
452 |
$8K |
| K0738 |
Portable gas oxygen system |
334 |
290 |
$8K |
| B4088 |
Gastro/jejuno tube, low-pro |
120 |
94 |
$8K |
| E0570 |
Nebulizer with compression |
880 |
755 |
$8K |
| A4450 |
Non-waterproof tape |
2,352 |
2,010 |
$7K |
| E2601 |
Gen w/c cushion wdth < 22 in |
366 |
332 |
$7K |
| B4100 |
Food thickener oral |
258 |
193 |
$7K |
| A6446 |
Conform band s w>=3" <5"/yd |
269 |
241 |
$7K |
| E0100 |
Cane adjust/fixed with tip |
964 |
868 |
$5K |
| E0181 |
Press pad alternating w/ pum |
396 |
350 |
$5K |
| E0470 |
Rad w/o backup non-inv intfc |
189 |
148 |
$5K |
| A4402 |
Lubricant per ounce |
1,589 |
1,408 |
$4K |
| A4452 |
Waterproof tape |
168 |
148 |
$4K |
| L8000 |
Mastectomy bra |
244 |
189 |
$3K |
| A4623 |
Tracheostomy inner cannula |
137 |
105 |
$3K |
| A7002 |
Tubing used w suction pump |
734 |
591 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
2,673 |
1,864 |
$3K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
90 |
81 |
$3K |
| A4216 |
Sterile water/saline, 10 ml |
279 |
251 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
227 |
184 |
$2K |
| A4624 |
Tracheal suction tube |
69 |
50 |
$2K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
12 |
12 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
216 |
167 |
$2K |
| T4521 |
Adult size brief/diaper sm |
32 |
27 |
$2K |
| A6449 |
Lt compres band >=3" <5"/yd |
62 |
54 |
$1K |
| A7046 |
Repl water chamber, pap dev |
455 |
397 |
$1K |
| A4333 |
Urinary cath anchor device |
186 |
148 |
$1K |
| E0168 |
Heavyduty/wide commode chair |
13 |
13 |
$902.36 |
| K0195 |
Elevating whlchair leg rests |
371 |
271 |
$750.20 |
| A4628 |
Oropharyngeal suction cath |
80 |
63 |
$589.24 |
| A4331 |
Extension drainage tubing |
274 |
249 |
$504.17 |
| L8020 |
Mastectomy form |
31 |
26 |
$502.97 |
| L1902 |
Afo ankle gauntlet pre ots |
12 |
12 |
$492.30 |
| E0148 |
Heavyduty walker no wheels |
13 |
12 |
$487.18 |
| A4338 |
Indwelling catheter latex |
164 |
130 |
$440.57 |
| A7036 |
Pos airway press chinstrap |
59 |
54 |
$421.08 |
| K0001 |
Standard wheelchair |
12 |
12 |
$389.66 |
| A4310 |
Insert tray w/o bag/cath |
252 |
194 |
$358.08 |
| E0185 |
Gel pressure mattress pad |
29 |
25 |
$343.54 |
| L0120 |
Cerv flex n/adj foam pre ots |
25 |
24 |
$295.11 |
| A4332 |
Lube sterile packet |
94 |
64 |
$261.93 |
| A4311 |
Catheter w/o bag 2-way latex |
25 |
24 |
$134.97 |
| A9286 |
Any hygienic item, device |
66 |
60 |
$105.00 |
| L3260 |
Ambulatory surgical boot eac |
47 |
26 |
$104.69 |
| A7013 |
Disposable compressor filter |
297 |
272 |
$35.99 |