| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
60,324 |
59,772 |
$4.90M |
| T4541 |
Large disposable underpad |
61,705 |
61,630 |
$4.09M |
| T4527 |
Adult size pull-on lg |
17,040 |
17,033 |
$1.18M |
| A6250 |
Skin seal protect moisturizr |
35,655 |
35,644 |
$864K |
| A4927 |
Non-sterile gloves |
19,100 |
19,085 |
$673K |
| T4526 |
Adult size pull-on med |
11,303 |
11,300 |
$647K |
| A4335 |
Incontinence supply |
31,197 |
31,179 |
$474K |
| T4536 |
Reusable pull-on any size |
26,883 |
26,871 |
$449K |
| T4523 |
Adult size brief/diaper lg |
6,454 |
6,425 |
$428K |
| T4528 |
Adult size pull-on xl |
6,830 |
6,724 |
$414K |
| E0295 |
Hosp bed semi-elect w/o matt |
8,435 |
8,407 |
$392K |
| T4537 |
Reusable underpad bed size |
9,333 |
9,331 |
$297K |
| T4522 |
Adult size brief/diaper med |
3,385 |
3,355 |
$226K |
| K0001 |
Standard wheelchair |
9,910 |
9,873 |
$204K |
| T4524 |
Adult size brief/diaper xl |
2,901 |
2,882 |
$160K |
| K0823 |
Pwc gp 2 std cap chair |
349 |
345 |
$140K |
| K0003 |
Lightweight wheelchair |
3,825 |
3,820 |
$114K |
| E0305 |
Rails bed side half length |
6,559 |
6,537 |
$105K |
| T4525 |
Adult size pull-on sm |
884 |
884 |
$67K |
| E0143 |
Walker folding wheeled w/o s |
1,326 |
1,317 |
$61K |
| E0630 |
Patient lift hydraulic |
1,144 |
1,143 |
$48K |
| E2611 |
Gen use back cush wdth <22in |
386 |
385 |
$38K |
| E0247 |
Trans bench w/wo comm open |
283 |
282 |
$35K |
| A9900 |
Supply/accessory/service |
4,758 |
4,755 |
$34K |
| K0002 |
Stnd hemi (low seat) whlchr |
1,242 |
1,240 |
$32K |
| E0163 |
Commode chair with fixed arm |
651 |
647 |
$30K |
| E0272 |
Mattress foam rubber |
287 |
284 |
$27K |
| E0245 |
Tub stool or bench |
275 |
273 |
$24K |
| K0195 |
Elevating whlchair leg rests |
2,781 |
2,767 |
$22K |
| E1038 |
Transport chair pt wt<=300lb |
1,927 |
1,921 |
$20K |
| E2601 |
Gen w/c cushion wdth < 22 in |
637 |
633 |
$16K |
| E0181 |
Press pad alternating w/ pum |
673 |
673 |
$11K |
| E0971 |
Wheelchair anti-tipping devi |
429 |
262 |
$11K |
| E0271 |
Mattress innerspring |
104 |
103 |
$9K |
| E0978 |
W/c acc,saf belt pelv strap |
538 |
537 |
$7K |
| E0961 |
Wheelchair brake extension |
317 |
199 |
$5K |
| K0821 |
Pwc gp 2 std port cap chair |
12 |
12 |
$3K |
| E0165 |
Commode chair with detacharm |
188 |
187 |
$2K |
| E0156 |
Walker seat attachment |
40 |
40 |
$573.41 |
| E0910 |
Trapeze bar attached to bed |
41 |
41 |
$443.17 |
| E0570 |
Nebulizer with compression |
26 |
26 |
$93.34 |