| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4543 |
Adult disp brief/diap abv xl |
11,069 |
10,445 |
$1.39M |
| A4554 |
Disposable underpads |
37,906 |
37,513 |
$1.38M |
| T4527 |
Adult size pull-on lg |
11,368 |
10,849 |
$1.30M |
| T4528 |
Adult size pull-on xl |
9,150 |
8,561 |
$1.30M |
| T4526 |
Adult size pull-on med |
10,436 |
10,137 |
$969K |
| T4544 |
Adlt disp und/pull on abv xl |
2,153 |
2,122 |
$426K |
| A4335 |
Incontinence supply |
43,191 |
42,880 |
$232K |
| K0823 |
Pwc gp 2 std cap chair |
2,664 |
2,649 |
$212K |
| A6250 |
Skin seal protect moisturizr |
38,927 |
38,666 |
$184K |
| T4525 |
Adult size pull-on sm |
2,173 |
2,081 |
$167K |
| E1390 |
Oxygen concentrator |
2,468 |
2,443 |
$129K |
| T4523 |
Adult size brief/diaper lg |
962 |
940 |
$97K |
| E0260 |
Hosp bed semi-electr w/ matt |
487 |
473 |
$58K |
| E0973 |
W/ch access det adj armrest |
2,612 |
1,585 |
$55K |
| T4522 |
Adult size brief/diaper med |
567 |
546 |
$48K |
| B4150 |
Ef complet w/intact nutrient |
343 |
279 |
$45K |
| E0277 |
Powered pres-redu air mattrs |
313 |
278 |
$38K |
| E1399 |
Durable medical equipment mi |
691 |
386 |
$37K |
| K0003 |
Lightweight wheelchair |
3,969 |
3,927 |
$36K |
| A4670 |
Automatic bp monitor, dial |
641 |
630 |
$31K |
| E2363 |
Gr24 sealed leadacid battery |
397 |
379 |
$30K |
| T4524 |
Adult size brief/diaper xl |
222 |
217 |
$28K |
| A4927 |
Non-sterile gloves |
2,948 |
2,929 |
$22K |
| A4253 |
Blood glucose/reagent strips |
1,928 |
1,766 |
$21K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,428 |
1,267 |
$21K |
| E0570 |
Nebulizer with compression |
2,758 |
2,679 |
$19K |
| K0108 |
W/c component-accessory nos |
603 |
289 |
$17K |
| E0431 |
Portable gaseous 02 |
1,098 |
1,088 |
$16K |
| E0630 |
Patient lift hydraulic |
649 |
646 |
$16K |
| E0240 |
Bath/shower chair |
120 |
117 |
$15K |
| E0261 |
Hosp bed semi-electr w/o mat |
3,799 |
3,721 |
$15K |
| A4556 |
Electrodes, pair |
326 |
318 |
$14K |
| B4154 |
Ef spec metabolic noninherit |
76 |
63 |
$11K |
| E0971 |
Wheelchair anti-tipping devi |
742 |
474 |
$11K |
| A4239 |
Non-adju cgm supply allow |
134 |
130 |
$8K |
| E2611 |
Gen use back cush wdth <22in |
112 |
106 |
$6K |
| E0143 |
Walker folding wheeled w/o s |
277 |
271 |
$6K |
| K0195 |
Elevating whlchair leg rests |
2,336 |
2,322 |
$6K |
| K0001 |
Standard wheelchair |
975 |
920 |
$6K |
| E2386 |
Foam filled drive wheel tire |
131 |
92 |
$5K |
| A4259 |
Lancets per box |
1,677 |
1,654 |
$4K |
| K0821 |
Pwc gp 2 std port cap chair |
129 |
129 |
$4K |
| E2387 |
Foam filled caster tire |
92 |
91 |
$4K |
| T4535 |
Disposable liner/shield/pad |
93 |
89 |
$3K |
| E0940 |
Trapeze bar free standing |
97 |
93 |
$3K |
| K0006 |
Heavy duty wheelchair |
223 |
223 |
$3K |
| E0184 |
Dry pressure mattress |
118 |
115 |
$3K |
| E0910 |
Trapeze bar attached to bed |
264 |
247 |
$3K |
| E2394 |
Drive wheel excludes tire |
144 |
91 |
$3K |
| A4245 |
Alcohol wipes per box |
1,450 |
1,422 |
$3K |
| E0951 |
Loop heel |
459 |
296 |
$2K |
| K0462 |
Temporary replacement eqpmnt |
371 |
358 |
$2K |
| E1028 |
W/c manual swingaway |
16 |
12 |
$1K |
| E2601 |
Gen w/c cushion wdth < 22 in |
85 |
81 |
$1K |
| E2375 |
Non-expandable controller |
107 |
107 |
$1K |
| A7003 |
Nebulizer administration set |
409 |
395 |
$918.67 |
| A4256 |
Calibrator solution/chips |
902 |
892 |
$836.59 |
| E2366 |
Battery charger, single mode |
13 |
13 |
$371.16 |
| A4258 |
Lancet device each |
479 |
476 |
$334.16 |
| E1392 |
Portable oxygen concentrator |
142 |
142 |
$326.14 |
| E0163 |
Commode chair with fixed arm |
13 |
12 |
$294.99 |
| E0149 |
Heavy duty wheeled walker |
64 |
63 |
$229.02 |
| A7015 |
Aerosol mask used w nebulize |
223 |
213 |
$189.10 |
| E0607 |
Blood glucose monitor home |
33 |
33 |
$107.55 |
| A7013 |
Disposable compressor filter |
84 |
81 |
$44.04 |
| E0156 |
Walker seat attachment |
121 |
121 |
$43.56 |
| A4357 |
Bedside drainage bag |
12 |
12 |
$32.13 |