| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
7,298 |
7,265 |
$491K |
| T4527 |
Adult size pull-on lg |
2,746 |
2,739 |
$387K |
| T4535 |
Disposable liner/shield/pad |
5,694 |
5,661 |
$273K |
| T4526 |
Adult size pull-on med |
1,666 |
1,663 |
$225K |
| T4528 |
Adult size pull-on xl |
1,195 |
1,192 |
$210K |
| A4927 |
Non-sterile gloves |
5,145 |
5,095 |
$74K |
| E0240 |
Bath/shower chair |
634 |
631 |
$64K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,940 |
3,842 |
$60K |
| E0143 |
Walker folding wheeled w/o s |
2,359 |
2,317 |
$45K |
| K0001 |
Standard wheelchair |
5,612 |
5,413 |
$40K |
| T4544 |
Adlt disp und/pull on abv xl |
90 |
89 |
$25K |
| E0601 |
Cont airway pressure device |
945 |
917 |
$23K |
| A4670 |
Automatic bp monitor, dial |
344 |
341 |
$21K |
| E0250 |
Hosp bed fixed ht w/ mattres |
1,390 |
1,350 |
$21K |
| K0195 |
Elevating whlchair leg rests |
4,661 |
4,516 |
$11K |
| K0003 |
Lightweight wheelchair |
1,111 |
1,079 |
$11K |
| A4604 |
Tubing with heating element |
629 |
593 |
$10K |
| E0156 |
Walker seat attachment |
2,146 |
2,108 |
$10K |
| E0255 |
Hospital bed var ht w/ mattr |
533 |
531 |
$9K |
| T4523 |
Adult size brief/diaper lg |
78 |
78 |
$9K |
| A7030 |
Cpap full face mask |
200 |
192 |
$7K |
| E0630 |
Patient lift hydraulic |
464 |
460 |
$6K |
| E0149 |
Heavy duty wheeled walker |
1,045 |
1,017 |
$6K |
| E0570 |
Nebulizer with compression |
1,597 |
1,566 |
$4K |
| E0163 |
Commode chair with fixed arm |
215 |
210 |
$4K |
| K0823 |
Pwc gp 2 std cap chair |
99 |
99 |
$4K |
| A7038 |
Pos airway pressure filter |
970 |
942 |
$3K |
| A7031 |
Replacement facemask interfa |
172 |
166 |
$3K |
| E2611 |
Gen use back cush wdth <22in |
93 |
89 |
$3K |
| E0243 |
Toilet rail |
44 |
44 |
$2K |
| E0635 |
Patient lift electric |
234 |
221 |
$2K |
| A7034 |
Nasal application device |
78 |
73 |
$2K |
| A7035 |
Pos airway press headgear |
205 |
194 |
$2K |
| E0244 |
Toilet seat raised |
55 |
54 |
$1K |
| E1390 |
Oxygen concentrator |
37 |
37 |
$957.27 |
| E0910 |
Trapeze bar attached to bed |
308 |
289 |
$801.53 |
| E2601 |
Gen w/c cushion wdth < 22 in |
110 |
105 |
$765.73 |
| E0185 |
Gel pressure mattress pad |
25 |
25 |
$686.89 |
| E1038 |
Transport chair pt wt<=300lb |
285 |
264 |
$566.83 |
| K0006 |
Heavy duty wheelchair |
26 |
24 |
$235.97 |
| E0100 |
Cane adjust/fixed with tip |
36 |
34 |
$206.47 |
| A7046 |
Repl water chamber, pap dev |
26 |
25 |
$131.94 |
| A7037 |
Pos airway pressure tubing |
39 |
39 |
$129.60 |