| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
49,786 |
49,574 |
$7.25M |
| A4554 |
Disposable underpads |
81,006 |
79,627 |
$5.57M |
| T4523 |
Adult size brief/diaper lg |
22,879 |
22,454 |
$2.51M |
| T4537 |
Reusable underpad bed size |
76,007 |
74,686 |
$2.30M |
| T4539 |
Reuse diaper/brief any size |
65,366 |
64,241 |
$1.90M |
| T4524 |
Adult size brief/diaper xl |
15,078 |
14,888 |
$1.79M |
| T4522 |
Adult size brief/diaper med |
19,037 |
18,676 |
$1.65M |
| T4535 |
Disposable liner/shield/pad |
31,700 |
31,141 |
$1.09M |
| L0642 |
Lo sag ri an/pos pnl pre ots |
4,745 |
4,703 |
$993K |
| L2630 |
Pelvic control band & belt u |
5,383 |
5,335 |
$963K |
| T4540 |
Reusable underpad chair size |
54,497 |
53,368 |
$922K |
| A4287 |
Disp col sto bag breast milk |
10,364 |
10,260 |
$428K |
| T4533 |
Youth size brief/diaper |
4,720 |
4,711 |
$316K |
| L0621 |
Sio flex pelvic/sacr pre ots |
5,566 |
5,359 |
$307K |
| A4927 |
Non-sterile gloves |
69,140 |
67,844 |
$280K |
| T4521 |
Adult size brief/diaper sm |
3,332 |
3,325 |
$262K |
| A6539 |
Gc stocking waistlngth 18-30 |
1,959 |
1,564 |
$212K |
| A6540 |
Gc stocking waistlngth 30-40 |
1,207 |
1,032 |
$186K |
| A5120 |
Skin barrier, wipe or swab |
19,979 |
19,946 |
$150K |
| A6530 |
Compression stocking bk18-30 |
7,688 |
4,042 |
$149K |
| T4543 |
Adult disp brief/diap abv xl |
829 |
828 |
$143K |
| L0649 |
Lso sc r pos/lat pnl pre ots |
804 |
800 |
$116K |
| A4670 |
Automatic bp monitor, dial |
2,317 |
2,293 |
$112K |
| K1005 |
Disp col sto bag breast milk |
1,942 |
1,911 |
$79K |
| A4510 |
Full length surg stocking |
547 |
293 |
$40K |
| T4541 |
Large disposable underpad |
710 |
710 |
$34K |
| A4402 |
Lubricant per ounce |
3,767 |
3,740 |
$33K |
| T4530 |
Ped size brief/diaper lg |
335 |
335 |
$22K |
| T4526 |
Adult size pull-on med |
328 |
328 |
$20K |
| E0570 |
Nebulizer with compression |
170 |
170 |
$13K |
| K0001 |
Standard wheelchair |
459 |
456 |
$11K |
| E0143 |
Walker folding wheeled w/o s |
99 |
99 |
$4K |
| K0195 |
Elevating whlchair leg rests |
486 |
482 |
$3K |
| A7005 |
Nondisposable nebulizer set |
183 |
183 |
$2K |
| E2611 |
Gen use back cush wdth <22in |
12 |
12 |
$918.99 |
| E0971 |
Wheelchair anti-tipping devi |
12 |
12 |
$344.44 |
| E0978 |
W/c acc,saf belt pelv strap |
24 |
24 |
$309.85 |
| E0156 |
Walker seat attachment |
24 |
24 |
$305.84 |
| E0961 |
Wheelchair brake extension |
12 |
12 |
$147.98 |
| A7015 |
Aerosol mask used w nebulize |
183 |
183 |
$131.35 |