| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4153 |
Ef hydrolyzed/amino acids |
5,099 |
4,291 |
$720K |
| T4528 |
Adult size pull-on xl |
9,395 |
8,043 |
$445K |
| E0147 |
Walker variable wheel resist |
1,021 |
1,008 |
$101K |
| B4150 |
Ef complet w/intact nutrient |
2,110 |
1,963 |
$92K |
| T4535 |
Disposable liner/shield/pad |
2,415 |
2,239 |
$64K |
| A4554 |
Disposable underpads |
7,592 |
6,234 |
$55K |
| T4526 |
Adult size pull-on med |
636 |
467 |
$26K |
| A4670 |
Automatic bp monitor, dial |
860 |
846 |
$20K |
| E0245 |
Tub stool or bench |
1,292 |
1,271 |
$20K |
| E0445 |
Oximeter non-invasive |
40 |
40 |
$14K |
| A4927 |
Non-sterile gloves |
2,663 |
2,330 |
$11K |
| T4522 |
Adult size brief/diaper med |
265 |
203 |
$11K |
| E0163 |
Commode chair with fixed arm |
607 |
602 |
$10K |
| B4154 |
Ef spec metabolic noninherit |
472 |
456 |
$8K |
| E0244 |
Toilet seat raised |
394 |
390 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
426 |
416 |
$6K |
| E0241 |
Bath tub wall rail |
448 |
431 |
$6K |
| E0156 |
Walker seat attachment |
1,378 |
1,316 |
$5K |
| E1038 |
Transport chair pt wt<=300lb |
110 |
104 |
$5K |
| E0100 |
Cane adjust/fixed with tip |
471 |
467 |
$4K |
| E0305 |
Rails bed side half length |
76 |
75 |
$3K |
| A4520 |
Incontinence garment anytype |
2,710 |
2,287 |
$3K |
| E1399 |
Durable medical equipment mi |
1,571 |
1,399 |
$2K |
| B4152 |
Ef calorie dense>/=1.5kcal |
64 |
59 |
$1K |
| E0246 |
Transfer tub rail attachment |
28 |
26 |
$1K |
| E0570 |
Nebulizer with compression |
44 |
41 |
$1K |
| A4335 |
Incontinence supply |
2,042 |
1,678 |
$743.42 |
| E0705 |
Transfer device |
28 |
28 |
$689.08 |
| A6250 |
Skin seal protect moisturizr |
81 |
61 |
$81.07 |
| E0159 |
Brake for wheeled walker |
27 |
27 |
$65.07 |
| A6446 |
Conform band s w>=3" <5"/yd |
13 |
12 |
$26.85 |
| T4541 |
Large disposable underpad |
13 |
12 |
$13.23 |