| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
17,941 |
17,428 |
$1.15M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
6,078 |
5,945 |
$736K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
13,339 |
12,968 |
$592K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,445 |
4,349 |
$538K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,247 |
3,188 |
$500K |
| K0003 |
Lightweight wheelchair |
6,733 |
6,285 |
$275K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,839 |
2,558 |
$274K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,102 |
1,060 |
$242K |
| A4927 |
Gloves, non-sterile, per 100 |
14,744 |
14,296 |
$169K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,386 |
3,179 |
$124K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
1,239 |
1,183 |
$116K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,140 |
1,079 |
$103K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
651 |
635 |
$71K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
650 |
628 |
$65K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,613 |
2,319 |
$47K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
332 |
305 |
$43K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
667 |
628 |
$43K |
| A4670 |
Automatic blood pressure monitor |
677 |
657 |
$38K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
685 |
616 |
$31K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
234 |
225 |
$31K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
455 |
431 |
$28K |
| E0601 |
Continuous positive airway pressure (cpap) device |
493 |
463 |
$28K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
272 |
260 |
$25K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
454 |
409 |
$19K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
415 |
412 |
$15K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
683 |
614 |
$14K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
1,405 |
1,382 |
$12K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
599 |
542 |
$12K |
| E0277 |
Powered pressure-reducing air mattress |
47 |
38 |
$9K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
56 |
50 |
$9K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
157 |
131 |
$9K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
134 |
129 |
$9K |
| E0570 |
Nebulizer, with compressor |
84 |
79 |
$6K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
84 |
69 |
$3K |
| E0156 |
Seat attachment, walker |
229 |
216 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
127 |
126 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
378 |
378 |
$919.46 |
| A4663 |
Blood pressure cuff only |
34 |
34 |
$355.58 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
37 |
37 |
$309.30 |