| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
28,332 |
19,002 |
$3.11M |
| T4541 |
Large disposable underpad |
16,107 |
15,500 |
$609K |
| T4526 |
Adult size pull-on med |
5,234 |
4,987 |
$496K |
| T4527 |
Adult size pull-on lg |
5,034 |
4,822 |
$493K |
| T4528 |
Adult size pull-on xl |
4,189 |
4,007 |
$473K |
| T4535 |
Disposable liner/shield/pad |
9,186 |
8,580 |
$430K |
| T4543 |
Adult disp brief/diap abv xl |
1,744 |
1,643 |
$373K |
| B4150 |
Ef complet w/intact nutrient |
5,195 |
3,222 |
$315K |
| T4537 |
Reusable underpad bed size |
2,842 |
2,704 |
$294K |
| T4523 |
Adult size brief/diaper lg |
1,631 |
1,446 |
$171K |
| A4927 |
Non-sterile gloves |
9,053 |
8,433 |
$146K |
| T4536 |
Reusable pull-on any size |
1,109 |
1,051 |
$124K |
| T4522 |
Adult size brief/diaper med |
1,060 |
1,024 |
$113K |
| B4154 |
Ef spec metabolic noninherit |
966 |
592 |
$96K |
| T4544 |
Adlt disp und/pull on abv xl |
399 |
386 |
$92K |
| T4540 |
Reusable underpad chair size |
1,859 |
1,777 |
$89K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,741 |
2,448 |
$89K |
| T4524 |
Adult size brief/diaper xl |
465 |
438 |
$50K |
| E1390 |
Oxygen concentrator |
1,802 |
1,646 |
$50K |
| B4152 |
Ef calorie dense>/=1.5kcal |
523 |
324 |
$48K |
| K0001 |
Standard wheelchair |
1,612 |
1,472 |
$38K |
| E0601 |
Cont airway pressure device |
1,446 |
1,299 |
$36K |
| K0738 |
Portable gas oxygen system |
1,299 |
1,200 |
$23K |
| E0570 |
Nebulizer with compression |
2,305 |
2,143 |
$13K |
| T4525 |
Adult size pull-on sm |
122 |
102 |
$8K |
| E0245 |
Tub stool or bench |
185 |
176 |
$8K |
| E0562 |
Humidifier heated used w pap |
494 |
455 |
$7K |
| E0244 |
Toilet seat raised |
67 |
61 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
79 |
69 |
$2K |
| E1038 |
Transport chair pt wt<=300lb |
170 |
140 |
$2K |
| A4670 |
Automatic bp monitor, dial |
39 |
39 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
225 |
153 |
$1K |
| A4357 |
Bedside drainage bag |
202 |
169 |
$902.04 |
| E0156 |
Walker seat attachment |
82 |
77 |
$626.23 |
| A4604 |
Tubing with heating element |
32 |
27 |
$235.73 |
| A7038 |
Pos airway pressure filter |
135 |
116 |
$221.03 |
| E0627 |
Seat lift mech, electric any |
15 |
15 |
$146.03 |
| A7035 |
Pos airway press headgear |
20 |
15 |
$59.44 |
| A7046 |
Repl water chamber, pap dev |
18 |
14 |
$24.00 |