| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
32,716 |
30,387 |
$1.00M |
| T4527 |
Adult size pull-on lg |
11,060 |
10,331 |
$869K |
| T4526 |
Adult size pull-on med |
8,965 |
8,381 |
$683K |
| T4528 |
Adult size pull-on xl |
6,580 |
6,207 |
$595K |
| T4523 |
Adult size brief/diaper lg |
5,294 |
4,877 |
$475K |
| T4524 |
Adult size brief/diaper xl |
3,854 |
3,581 |
$401K |
| T4535 |
Disposable liner/shield/pad |
14,738 |
13,744 |
$292K |
| T4522 |
Adult size brief/diaper med |
3,740 |
3,522 |
$245K |
| K0001 |
Standard wheelchair |
6,729 |
6,217 |
$238K |
| T4544 |
Adlt disp und/pull on abv xl |
1,420 |
1,290 |
$217K |
| T4525 |
Adult size pull-on sm |
2,309 |
2,150 |
$168K |
| K0816 |
Pwc gp 1 std cap chair |
1,217 |
1,116 |
$164K |
| E0245 |
Tub stool or bench |
2,136 |
2,002 |
$137K |
| E0143 |
Walker folding wheeled w/o s |
2,929 |
2,670 |
$82K |
| K0002 |
Stnd hemi (low seat) whlchr |
3,020 |
2,821 |
$70K |
| T4521 |
Adult size brief/diaper sm |
1,055 |
984 |
$67K |
| E0261 |
Hosp bed semi-electr w/o mat |
5,223 |
4,857 |
$60K |
| E0630 |
Patient lift hydraulic |
1,572 |
1,447 |
$46K |
| E0570 |
Nebulizer with compression |
2,872 |
2,741 |
$38K |
| E2611 |
Gen use back cush wdth <22in |
903 |
790 |
$32K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,607 |
1,464 |
$31K |
| E0260 |
Hosp bed semi-electr w/ matt |
525 |
480 |
$30K |
| K0195 |
Elevating whlchair leg rests |
2,277 |
2,100 |
$28K |
| E0163 |
Commode chair with fixed arm |
762 |
713 |
$25K |
| E0951 |
Loop heel |
1,812 |
1,660 |
$20K |
| K0800 |
Pov group 1 std up to 300lbs |
54 |
42 |
$17K |
| A4670 |
Automatic bp monitor, dial |
352 |
333 |
$16K |
| E0978 |
W/c acc,saf belt pelv strap |
1,279 |
1,147 |
$15K |
| E0244 |
Toilet seat raised |
320 |
302 |
$13K |
| E0149 |
Heavy duty wheeled walker |
444 |
414 |
$11K |
| E0184 |
Dry pressure mattress |
373 |
339 |
$10K |
| K0006 |
Heavy duty wheelchair |
72 |
66 |
$9K |
| E0247 |
Trans bench w/wo comm open |
139 |
116 |
$8K |
| E0971 |
Wheelchair anti-tipping devi |
238 |
227 |
$7K |
| A4357 |
Bedside drainage bag |
547 |
530 |
$7K |
| E0156 |
Walker seat attachment |
1,362 |
1,237 |
$6K |
| E1038 |
Transport chair pt wt<=300lb |
1,321 |
1,263 |
$5K |
| K0739 |
Repair/svc dme non-oxygen eq |
441 |
421 |
$4K |
| E0277 |
Powered pres-redu air mattrs |
25 |
24 |
$4K |
| A4456 |
Adhesive remover, wipes |
156 |
151 |
$2K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
27 |
25 |
$1K |
| E0165 |
Commode chair with detacharm |
54 |
50 |
$1K |
| A7003 |
Nebulizer administration set |
438 |
435 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
140 |
137 |
$996.91 |
| A4385 |
Ost skn barrier sld ext wear |
13 |
13 |
$985.08 |
| A5120 |
Skin barrier, wipe or swab |
79 |
77 |
$711.23 |
| A7005 |
Nondisposable nebulizer set |
14 |
13 |
$105.49 |
| A4371 |
Skin barrier powder per oz |
25 |
25 |
$99.43 |