| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
57,563 |
54,832 |
$3.98M |
| T4526 |
Adult size pull-on med |
51,003 |
48,184 |
$3.44M |
| T4528 |
Adult size pull-on xl |
34,825 |
33,050 |
$2.47M |
| A4554 |
Disposable underpads |
86,348 |
78,540 |
$2.38M |
| B4161 |
Ef ped hydrolyzed/amino acid |
3,830 |
2,308 |
$2.13M |
| T4541 |
Large disposable underpad |
37,977 |
33,170 |
$1.88M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
15,006 |
10,426 |
$1.67M |
| T4535 |
Disposable liner/shield/pad |
34,624 |
32,644 |
$1.62M |
| E1399 |
Durable medical equipment mi |
6,817 |
4,242 |
$1.58M |
| T4524 |
Adult size brief/diaper xl |
18,210 |
16,691 |
$1.47M |
| E1390 |
Oxygen concentrator |
15,243 |
11,872 |
$1.45M |
| B4150 |
Ef complet w/intact nutrient |
14,809 |
12,208 |
$1.38M |
| T4534 |
Youth size pull-on |
14,749 |
9,427 |
$1.24M |
| T4523 |
Adult size brief/diaper lg |
17,450 |
15,590 |
$1.20M |
| S5199 |
Personal care item nos each |
91,732 |
79,758 |
$1.02M |
| B4149 |
Ef blenderized foods |
3,365 |
1,842 |
$997K |
| A4927 |
Non-sterile gloves |
117,525 |
107,063 |
$957K |
| B4152 |
Ef calorie dense>/=1.5kcal |
6,952 |
5,494 |
$942K |
| B4035 |
Enteral feed supp pump per d |
6,798 |
4,742 |
$915K |
| B4153 |
Ef hydrolyzed/amino acids |
1,485 |
829 |
$833K |
| T4522 |
Adult size brief/diaper med |
12,716 |
10,494 |
$819K |
| B4154 |
Ef spec metabolic noninherit |
5,135 |
4,463 |
$680K |
| B4088 |
Gastro/jejuno tube, low-pro |
7,938 |
3,574 |
$637K |
| A4353 |
Intermittent urinary cath |
1,081 |
788 |
$510K |
| E0465 |
Home vent invasive interface |
1,228 |
806 |
$497K |
| E0601 |
Cont airway pressure device |
11,144 |
8,715 |
$482K |
| T4525 |
Adult size pull-on sm |
6,637 |
6,195 |
$446K |
| T4544 |
Adlt disp und/pull on abv xl |
4,085 |
3,737 |
$413K |
| B9998 |
Enteral supp not otherwise c |
7,115 |
3,974 |
$413K |
| A4624 |
Tracheal suction tube |
3,424 |
2,202 |
$368K |
| T4543 |
Adult disp brief/diap abv xl |
3,377 |
3,103 |
$361K |
| T4530 |
Ped size brief/diaper lg |
5,800 |
3,950 |
$342K |
| B9002 |
Enter nutr inf pump any type |
7,784 |
5,938 |
$332K |
| E0431 |
Portable gaseous 02 |
12,462 |
9,588 |
$271K |
| B4034 |
Enter feed supkit syr by day |
4,331 |
3,036 |
$269K |
| E0471 |
Rad w/backup non inv intrfc |
1,273 |
928 |
$268K |
| E0445 |
Oximeter non-invasive |
5,864 |
4,327 |
$266K |
| E0466 |
Home vent non-invasive inter |
639 |
474 |
$260K |
| A9900 |
Supply/accessory/service |
4,091 |
2,549 |
$251K |
| K0001 |
Standard wheelchair |
9,334 |
6,979 |
$197K |
| A6250 |
Skin seal protect moisturizr |
32,016 |
29,603 |
$179K |
| T4532 |
Ped size pull-on lg |
2,185 |
1,526 |
$176K |
| B4155 |
Ef incomplete/modular |
1,887 |
821 |
$175K |
| A4245 |
Alcohol wipes per box |
20,897 |
20,016 |
$134K |
| E0470 |
Rad w/o backup non-inv intfc |
1,451 |
1,143 |
$129K |
| E0255 |
Hospital bed var ht w/ mattr |
2,322 |
1,759 |
$126K |
| E0562 |
Humidifier heated used w pap |
14,375 |
11,207 |
$119K |
| E0570 |
Nebulizer with compression |
2,630 |
2,088 |
$116K |
| T4540 |
Reusable underpad chair size |
3,854 |
3,501 |
$111K |
| T4521 |
Adult size brief/diaper sm |
1,878 |
1,344 |
$107K |
| B4157 |
Ef special metabolic inherit |
83 |
64 |
$101K |
| A4335 |
Incontinence supply |
41,504 |
39,769 |
$99K |
| A4629 |
Tracheostomy care kit |
1,860 |
1,173 |
$87K |
| A4351 |
Straight tip urine catheter |
865 |
566 |
$82K |
| A6212 |
Foam drg <=16 sq in w/border |
380 |
251 |
$64K |
| E0143 |
Walker folding wheeled w/o s |
1,371 |
1,034 |
$63K |
| A6402 |
Sterile gauze <= 16 sq in |
5,676 |
3,955 |
$63K |
| A6197 |
Alginate drsg >16 <=48 sq in |
167 |
95 |
$61K |
| A5120 |
Skin barrier, wipe or swab |
14,479 |
13,171 |
$60K |
| A7520 |
Trach/laryn tube non-cuffed |
1,141 |
550 |
$60K |
| E0260 |
Hosp bed semi-electr w/ matt |
657 |
444 |
$59K |
| A4623 |
Tracheostomy inner cannula |
1,158 |
615 |
$59K |
| E0600 |
Suction pump portab hom modl |
3,014 |
2,243 |
$56K |
| B4100 |
Food thickener oral |
816 |
621 |
$56K |
| A4349 |
Disposable male external cat |
1,672 |
1,233 |
$53K |
| A4357 |
Bedside drainage bag |
2,572 |
1,966 |
$51K |
| A7003 |
Nebulizer administration set |
4,442 |
3,303 |
$48K |
| A7508 |
Housing & integrated adhesiv |
1,376 |
854 |
$47K |
| E0619 |
Apnea monitor w recorder |
478 |
337 |
$44K |
| E1392 |
Portable oxygen concentrator |
2,843 |
2,319 |
$41K |
| A4322 |
Irrigation syringe |
1,825 |
1,153 |
$41K |
| A4213 |
20+ cc syringe only |
752 |
500 |
$38K |
| K0195 |
Elevating whlchair leg rests |
4,255 |
2,782 |
$37K |
| E0630 |
Patient lift hydraulic |
1,217 |
902 |
$37K |
| A4450 |
Non-waterproof tape |
1,657 |
1,108 |
$34K |
| A7526 |
Tracheostomy tube collar |
2,356 |
1,344 |
$31K |
| T4529 |
Ped size brief/diaper sm/med |
913 |
600 |
$31K |
| A9270 |
Non-covered item or service |
2,000 |
1,695 |
$30K |
| B4102 |
Ef adult fluids and electro |
103 |
100 |
$30K |
| T4533 |
Youth size brief/diaper |
400 |
288 |
$29K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
511 |
307 |
$27K |
| A4452 |
Waterproof tape |
911 |
545 |
$26K |
| E0565 |
Compressor air power source |
1,703 |
1,284 |
$25K |
| E0277 |
Powered pres-redu air mattrs |
217 |
141 |
$22K |
| T5999 |
Supply, nos |
71 |
59 |
$20K |
| E0163 |
Commode chair with fixed arm |
591 |
414 |
$18K |
| E0550 |
Humidif extens supple w ippb |
851 |
616 |
$17K |
| K0006 |
Heavy duty wheelchair |
568 |
393 |
$17K |
| E0603 |
Electric breast pump |
448 |
197 |
$16K |
| A7521 |
Trach/laryn tube cuffed |
399 |
167 |
$16K |
| K0007 |
Extra heavy duty wheelchair |
274 |
197 |
$15K |
| A7000 |
Disposable canister for pump |
1,349 |
853 |
$15K |
| A4425 |
Ost pch drain for barrier fl |
393 |
217 |
$13K |
| E1235 |
Rigid ped wc adjustable |
171 |
98 |
$13K |
| E0443 |
Portable 02 contents, gas |
562 |
252 |
$12K |
| E0776 |
Iv pole |
1,466 |
1,086 |
$12K |
| A4358 |
Urinary leg or abdomen bag |
1,170 |
809 |
$11K |
| A7002 |
Tubing used w suction pump |
2,980 |
1,939 |
$9K |
| K0003 |
Lightweight wheelchair |
331 |
221 |
$9K |
| A4618 |
Breathing circuits |
792 |
467 |
$9K |
| A4456 |
Adhesive remover, wipes |
1,083 |
672 |
$8K |
| A4406 |
Pectin based ostomy paste |
641 |
366 |
$8K |
| A4338 |
Indwelling catheter latex |
683 |
486 |
$8K |
| A6216 |
Non-sterile gauze<=16 sq in |
1,589 |
1,036 |
$8K |
| A5063 |
Drain ostomy pouch w/flange |
288 |
159 |
$7K |
| E1060 |
Wheelchair detachable arms |
192 |
128 |
$6K |
| A4409 |
Ost skn barr convex <=4 sq i |
127 |
63 |
$6K |
| E0240 |
Bath/shower chair |
146 |
77 |
$5K |
| E0303 |
Hosp bed hvy dty xtra wide |
35 |
24 |
$5K |
| A4371 |
Skin barrier powder per oz |
557 |
289 |
$5K |
| A7015 |
Aerosol mask used w nebulize |
3,316 |
2,552 |
$4K |
| A4310 |
Insert tray w/o bag/cath |
121 |
108 |
$4K |
| E0156 |
Walker seat attachment |
225 |
148 |
$4K |
| T4537 |
Reusable underpad bed size |
102 |
99 |
$3K |
| A7013 |
Disposable compressor filter |
1,444 |
789 |
$3K |
| A4385 |
Ost skn barrier sld ext wear |
159 |
72 |
$3K |
| A5061 |
Pouch drainable w barrier at |
62 |
36 |
$2K |
| A7010 |
Disposable corrugated tubing |
421 |
263 |
$2K |
| A7525 |
Tracheostomy mask |
947 |
600 |
$2K |
| A6446 |
Conform band s w>=3" <5"/yd |
203 |
121 |
$2K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
15 |
12 |
$1K |
| A7007 |
Lg vol nebulizer disposable |
436 |
263 |
$975.06 |
| E1031 |
Rollabout chair with casters |
35 |
24 |
$895.19 |
| A4311 |
Catheter w/o bag 2-way latex |
230 |
169 |
$871.22 |
| E0245 |
Tub stool or bench |
39 |
30 |
$792.62 |
| A4333 |
Urinary cath anchor device |
33 |
13 |
$758.62 |
| A4332 |
Lube sterile packet |
141 |
75 |
$572.89 |
| A7012 |
Nebulizer water collec devic |
189 |
111 |
$182.03 |
| A7037 |
Pos airway pressure tubing |
23 |
14 |
$112.01 |
| A4244 |
Alcohol or peroxide per pint |
28 |
12 |
$33.69 |