| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
1,962 |
1,873 |
$233K |
| E1390 |
Oxygen concentrator |
3,532 |
3,448 |
$175K |
| T4526 |
Adult size pull-on med |
979 |
928 |
$100K |
| T4528 |
Adult size pull-on xl |
707 |
669 |
$94K |
| T4535 |
Disposable liner/shield/pad |
1,260 |
1,162 |
$84K |
| L3908 |
Who cock-up nonmolde pre ots |
1,745 |
1,517 |
$82K |
| L4361 |
Pneuma/vac walk boot pre ots |
306 |
298 |
$78K |
| E0570 |
Nebulizer with compression |
859 |
844 |
$64K |
| T4541 |
Large disposable underpad |
1,566 |
1,442 |
$58K |
| K0001 |
Standard wheelchair |
3,676 |
3,425 |
$51K |
| E0114 |
Crutch underarm pair no wood |
1,141 |
1,115 |
$48K |
| E0250 |
Hosp bed fixed ht w/ mattres |
1,626 |
1,513 |
$44K |
| E0601 |
Cont airway pressure device |
1,413 |
1,295 |
$40K |
| E0118 |
Crutch substitute |
936 |
912 |
$40K |
| T4522 |
Adult size brief/diaper med |
234 |
213 |
$31K |
| A4604 |
Tubing with heating element |
885 |
788 |
$27K |
| E0562 |
Humidifier heated used w pap |
1,240 |
1,177 |
$22K |
| B4035 |
Enteral feed supp pump per d |
85 |
81 |
$20K |
| A6530 |
Compression stocking bk18-30 |
502 |
347 |
$19K |
| E0431 |
Portable gaseous 02 |
1,723 |
1,687 |
$17K |
| L4387 |
Non-pneum walk boot pre ots |
177 |
174 |
$17K |
| A7031 |
Replacement facemask interfa |
529 |
512 |
$17K |
| T4523 |
Adult size brief/diaper lg |
91 |
90 |
$16K |
| E0143 |
Walker folding wheeled w/o s |
375 |
352 |
$16K |
| A7030 |
Cpap full face mask |
180 |
172 |
$15K |
| E0603 |
Electric breast pump |
131 |
129 |
$15K |
| A6212 |
Foam drg <=16 sq in w/border |
144 |
105 |
$13K |
| A7035 |
Pos airway press headgear |
558 |
541 |
$9K |
| L4360 |
Pneumat walking boot pre cst |
39 |
35 |
$8K |
| A4351 |
Straight tip urine catheter |
36 |
28 |
$7K |
| A7038 |
Pos airway pressure filter |
1,698 |
1,640 |
$7K |
| L1902 |
Afo ankle gauntlet pre ots |
102 |
100 |
$6K |
| A4927 |
Non-sterile gloves |
217 |
188 |
$5K |
| A4565 |
Slings |
563 |
535 |
$5K |
| K0195 |
Elevating whlchair leg rests |
532 |
468 |
$5K |
| K0003 |
Lightweight wheelchair |
162 |
147 |
$4K |
| B9002 |
Enter nutr inf pump any type |
29 |
26 |
$4K |
| E0184 |
Dry pressure mattress |
540 |
465 |
$4K |
| A7034 |
Nasal application device |
63 |
60 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
578 |
462 |
$3K |
| E0260 |
Hosp bed semi-electr w/ matt |
149 |
131 |
$3K |
| A4452 |
Waterproof tape |
291 |
242 |
$3K |
| A6446 |
Conform band s w>=3" <5"/yd |
122 |
95 |
$2K |
| E0305 |
Rails bed side half length |
389 |
326 |
$1K |
| A7046 |
Repl water chamber, pap dev |
148 |
147 |
$1K |
| L3260 |
Ambulatory surgical boot eac |
132 |
128 |
$1K |
| A7003 |
Nebulizer administration set |
620 |
599 |
$1K |
| A4335 |
Incontinence supply |
112 |
108 |
$1K |
| E2611 |
Gen use back cush wdth <22in |
28 |
25 |
$1K |
| L1830 |
Ko immob canvas long pre ots |
15 |
15 |
$1K |
| E0245 |
Tub stool or bench |
17 |
13 |
$937.37 |
| E0156 |
Walker seat attachment |
26 |
26 |
$316.37 |
| A4520 |
Incontinence garment anytype |
314 |
247 |
$0.00 |