| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
4,615 |
3,473 |
$493K |
| T4541 |
Large disposable underpad |
10,383 |
7,785 |
$454K |
| T4527 |
Adult size pull-on lg |
3,829 |
2,865 |
$420K |
| A4927 |
Non-sterile gloves |
26,545 |
17,346 |
$358K |
| T4535 |
Disposable liner/shield/pad |
6,833 |
4,857 |
$311K |
| T4526 |
Adult size pull-on med |
2,552 |
1,861 |
$278K |
| T4524 |
Adult size brief/diaper xl |
2,369 |
1,808 |
$264K |
| A7030 |
Cpap full face mask |
6,856 |
4,927 |
$264K |
| E1390 |
Oxygen concentrator |
10,818 |
8,115 |
$263K |
| E0601 |
Cont airway pressure device |
10,093 |
6,689 |
$207K |
| T4522 |
Adult size brief/diaper med |
2,554 |
1,816 |
$187K |
| A4604 |
Tubing with heating element |
10,679 |
7,378 |
$187K |
| T4528 |
Adult size pull-on xl |
1,703 |
1,268 |
$178K |
| A7034 |
Nasal application device |
5,856 |
4,067 |
$144K |
| A7031 |
Replacement facemask interfa |
6,567 |
4,727 |
$105K |
| E0570 |
Nebulizer with compression |
12,227 |
8,630 |
$100K |
| K0738 |
Portable gas oxygen system |
6,984 |
5,001 |
$90K |
| T4543 |
Adult disp brief/diap abv xl |
537 |
395 |
$89K |
| A4670 |
Automatic bp monitor, dial |
2,047 |
1,417 |
$86K |
| B4035 |
Enteral feed supp pump per d |
1,302 |
852 |
$85K |
| A6530 |
Compression stocking bk18-30 |
1,540 |
977 |
$80K |
| T4534 |
Youth size pull-on |
1,011 |
622 |
$77K |
| A7032 |
Replacement nasal cushion |
3,655 |
2,462 |
$64K |
| A7035 |
Pos airway press headgear |
7,750 |
5,509 |
$64K |
| E0562 |
Humidifier heated used w pap |
10,734 |
7,086 |
$60K |
| A4253 |
Blood glucose/reagent strips |
1,089 |
933 |
$44K |
| E0261 |
Hosp bed semi-electr w/o mat |
4,850 |
3,621 |
$40K |
| E0470 |
Rad w/o backup non-inv intfc |
1,060 |
674 |
$36K |
| A4322 |
Irrigation syringe |
1,584 |
854 |
$35K |
| A7005 |
Nondisposable nebulizer set |
3,246 |
2,303 |
$31K |
| A7033 |
Replacement nasal pillows |
1,797 |
1,300 |
$26K |
| A7038 |
Pos airway pressure filter |
12,457 |
8,856 |
$26K |
| A4520 |
Incontinence garment anytype |
950 |
345 |
$23K |
| E0143 |
Walker folding wheeled w/o s |
1,743 |
1,141 |
$20K |
| K0001 |
Standard wheelchair |
4,628 |
3,153 |
$19K |
| T4525 |
Adult size pull-on sm |
186 |
126 |
$15K |
| Q0513 |
Disp fee inhal drugs/30 days |
1,721 |
1,380 |
$13K |
| A7037 |
Pos airway pressure tubing |
1,576 |
1,309 |
$12K |
| B9998 |
Enteral supp not otherwise c |
751 |
309 |
$11K |
| A7046 |
Repl water chamber, pap dev |
2,387 |
1,544 |
$11K |
| L3908 |
Who cock-up nonmolde pre ots |
250 |
120 |
$7K |
| E0630 |
Patient lift hydraulic |
667 |
490 |
$7K |
| K0195 |
Elevating whlchair leg rests |
2,071 |
1,342 |
$6K |
| A4259 |
Lancets per box |
879 |
761 |
$6K |
| A4357 |
Bedside drainage bag |
1,393 |
994 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
382 |
188 |
$4K |
| E0156 |
Walker seat attachment |
557 |
337 |
$3K |
| J7613 |
Albuterol non-comp unit |
2,907 |
1,327 |
$3K |
| E0181 |
Press pad alternating w/ pum |
916 |
624 |
$3K |
| E0245 |
Tub stool or bench |
54 |
44 |
$3K |
| T4544 |
Adlt disp und/pull on abv xl |
26 |
14 |
$3K |
| A4245 |
Alcohol wipes per box |
901 |
678 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
851 |
551 |
$1K |
| A4554 |
Disposable underpads |
60 |
28 |
$1K |
| E1038 |
Transport chair pt wt<=300lb |
327 |
213 |
$955.04 |
| E0184 |
Dry pressure mattress |
57 |
41 |
$900.21 |
| A4358 |
Urinary leg or abdomen bag |
139 |
94 |
$771.69 |
| A7003 |
Nebulizer administration set |
490 |
397 |
$725.35 |
| E0971 |
Wheelchair anti-tipping devi |
492 |
177 |
$659.84 |
| A4349 |
Disposable male external cat |
12 |
12 |
$593.69 |
| A7015 |
Aerosol mask used w nebulize |
461 |
386 |
$333.97 |
| J7644 |
Ipratropium bromide non-comp |
271 |
112 |
$267.49 |
| E0163 |
Commode chair with fixed arm |
20 |
14 |
$166.63 |
| A7039 |
Filter, non disposable w pap |
50 |
41 |
$139.24 |
| J7626 |
Budesonide non-comp unit |
25 |
12 |
$101.08 |
| A4258 |
Lancet device each |
20 |
13 |
$94.56 |
| K0006 |
Heavy duty wheelchair |
24 |
12 |
$91.80 |
| A4402 |
Lubricant per ounce |
13 |
12 |
$48.81 |