| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
11,211 |
9,454 |
$705K |
| T4541 |
Large disposable underpad |
23,621 |
19,525 |
$672K |
| T4526 |
Adult size pull-on med |
10,319 |
8,654 |
$558K |
| T4528 |
Adult size pull-on xl |
7,176 |
5,817 |
$535K |
| T4544 |
Adlt disp und/pull on abv xl |
2,735 |
2,179 |
$270K |
| T4524 |
Adult size brief/diaper xl |
2,832 |
2,522 |
$236K |
| T4522 |
Adult size brief/diaper med |
3,359 |
3,016 |
$177K |
| T4523 |
Adult size brief/diaper lg |
3,134 |
2,830 |
$175K |
| T4543 |
Adult disp brief/diap abv xl |
1,483 |
1,278 |
$168K |
| E0601 |
Cont airway pressure device |
4,193 |
3,684 |
$104K |
| T4535 |
Disposable liner/shield/pad |
4,127 |
3,417 |
$81K |
| A4351 |
Straight tip urine catheter |
1,013 |
912 |
$76K |
| A7034 |
Nasal application device |
2,122 |
1,714 |
$62K |
| A4604 |
Tubing with heating element |
2,472 |
1,996 |
$47K |
| A7030 |
Cpap full face mask |
1,142 |
946 |
$47K |
| T4525 |
Adult size pull-on sm |
704 |
604 |
$43K |
| E0562 |
Humidifier heated used w pap |
1,952 |
1,704 |
$36K |
| A7032 |
Replacement nasal cushion |
1,626 |
1,329 |
$34K |
| A7031 |
Replacement facemask interfa |
1,645 |
1,354 |
$28K |
| A7033 |
Replacement nasal pillows |
1,483 |
1,225 |
$23K |
| A4927 |
Non-sterile gloves |
4,187 |
3,167 |
$23K |
| A7035 |
Pos airway press headgear |
2,154 |
1,804 |
$21K |
| A4520 |
Incontinence garment anytype |
541 |
328 |
$20K |
| A7038 |
Pos airway pressure filter |
6,077 |
5,057 |
$16K |
| A7046 |
Repl water chamber, pap dev |
1,113 |
910 |
$6K |
| B4152 |
Ef calorie dense>/=1.5kcal |
29 |
24 |
$6K |
| A7037 |
Pos airway pressure tubing |
435 |
373 |
$4K |
| A7000 |
Disposable canister for pump |
340 |
326 |
$2K |
| A4402 |
Lubricant per ounce |
500 |
473 |
$2K |
| A4628 |
Oropharyngeal suction cath |
328 |
316 |
$2K |
| A4357 |
Bedside drainage bag |
341 |
315 |
$2K |
| K0001 |
Standard wheelchair |
47 |
43 |
$1K |
| A7002 |
Tubing used w suction pump |
314 |
302 |
$694.97 |
| A4554 |
Disposable underpads |
99 |
59 |
$368.05 |
| K0195 |
Elevating whlchair leg rests |
25 |
24 |
$359.32 |
| A4450 |
Non-waterproof tape |
29 |
18 |
$9.75 |