| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4160 |
Ef ped caloric dense>/=0.7kc |
54,764 |
53,210 |
$8.90M |
| T4534 |
Youth size pull-on |
46,128 |
44,328 |
$5.41M |
| B4150 |
Ef complet w/intact nutrient |
40,720 |
38,692 |
$4.04M |
| T4532 |
Ped size pull-on lg |
32,600 |
31,574 |
$3.04M |
| T4526 |
Adult size pull-on med |
31,331 |
30,260 |
$2.91M |
| T4527 |
Adult size pull-on lg |
27,214 |
26,190 |
$2.53M |
| T4541 |
Large disposable underpad |
99,764 |
97,554 |
$2.31M |
| T4543 |
Adult disp brief/diap abv xl |
9,897 |
9,630 |
$2.07M |
| T4528 |
Adult size pull-on xl |
17,214 |
16,571 |
$1.79M |
| T4535 |
Disposable liner/shield/pad |
49,301 |
47,554 |
$1.72M |
| T4537 |
Reusable underpad bed size |
41,906 |
41,115 |
$1.60M |
| A4927 |
Non-sterile gloves |
85,926 |
81,050 |
$1.35M |
| T4530 |
Ped size brief/diaper lg |
15,876 |
15,268 |
$1.25M |
| E0570 |
Nebulizer with compression |
22,384 |
21,633 |
$1.22M |
| T4533 |
Youth size brief/diaper |
10,303 |
9,954 |
$1.00M |
| B4152 |
Ef calorie dense>/=1.5kcal |
8,193 |
7,788 |
$946K |
| T4522 |
Adult size brief/diaper med |
8,874 |
8,544 |
$866K |
| T4523 |
Adult size brief/diaper lg |
6,729 |
6,425 |
$742K |
| A4670 |
Automatic bp monitor, dial |
10,485 |
10,326 |
$534K |
| B4154 |
Ef spec metabolic noninherit |
4,081 |
3,811 |
$449K |
| T4524 |
Adult size brief/diaper xl |
3,267 |
3,118 |
$384K |
| T4521 |
Adult size brief/diaper sm |
3,141 |
3,038 |
$305K |
| A4253 |
Blood glucose/reagent strips |
8,082 |
7,521 |
$259K |
| E0143 |
Walker folding wheeled w/o s |
3,748 |
3,622 |
$175K |
| B4155 |
Ef incomplete/modular |
1,295 |
1,241 |
$160K |
| A6530 |
Compression stocking bk18-30 |
2,372 |
2,078 |
$125K |
| A4351 |
Straight tip urine catheter |
933 |
848 |
$119K |
| A4335 |
Incontinence supply |
1,500 |
1,415 |
$103K |
| A4239 |
Non-adju cgm supply allow |
880 |
870 |
$96K |
| L3908 |
Who cock-up nonmolde pre ots |
1,851 |
1,602 |
$83K |
| E0240 |
Bath/shower chair |
2,862 |
2,767 |
$78K |
| K0001 |
Standard wheelchair |
3,757 |
3,638 |
$77K |
| E0555 |
Humidifier for use w/ regula |
2,120 |
2,093 |
$72K |
| T4531 |
Ped size pull-on sm/med |
890 |
874 |
$71K |
| E0163 |
Commode chair with fixed arm |
1,705 |
1,631 |
$64K |
| A4595 |
Tens suppl 2 lead per month |
3,115 |
3,056 |
$60K |
| A7003 |
Nebulizer administration set |
35,427 |
34,550 |
$59K |
| L1810 |
Ko elastic with joints |
1,034 |
940 |
$51K |
| E0603 |
Electric breast pump |
310 |
308 |
$51K |
| E1399 |
Durable medical equipment mi |
347 |
314 |
$43K |
| E0156 |
Walker seat attachment |
3,764 |
3,660 |
$39K |
| B4103 |
Ef ped fluid and electrolyte |
590 |
581 |
$37K |
| A4259 |
Lancets per box |
7,657 |
7,285 |
$36K |
| B4161 |
Ef ped hydrolyzed/amino acid |
94 |
94 |
$36K |
| A7015 |
Aerosol mask used w nebulize |
30,084 |
29,335 |
$28K |
| E0100 |
Cane adjust/fixed with tip |
2,305 |
2,248 |
$23K |
| E0730 |
Tens four lead |
100 |
99 |
$22K |
| A4627 |
Spacer bag/reservoir |
788 |
784 |
$19K |
| E0105 |
Cane adjust/fixed quad/3 pro |
687 |
669 |
$16K |
| E0607 |
Blood glucose monitor home |
337 |
326 |
$12K |
| K0003 |
Lightweight wheelchair |
343 |
339 |
$11K |
| E0149 |
Heavy duty wheeled walker |
159 |
149 |
$10K |
| E0445 |
Oximeter non-invasive |
42 |
40 |
$8K |
| K0553 |
Ther cgm supply allowance |
66 |
63 |
$7K |
| A6533 |
Gc stocking thighlngth 18-30 |
88 |
84 |
$6K |
| T4529 |
Ped size brief/diaper sm/med |
67 |
63 |
$5K |
| A5500 |
Diab shoe for density insert |
138 |
90 |
$5K |
| L1812 |
Ko elastic w/joints pre ots |
60 |
57 |
$4K |
| A5513 |
Multi den insert custom mold |
148 |
101 |
$4K |
| L0625 |
Lo flex l1-below l5 pre ots |
147 |
147 |
$4K |
| L0626 |
Lo sag rig pnl stays pre cst |
102 |
101 |
$4K |
| E0605 |
Vaporizer room type |
188 |
183 |
$3K |
| E1038 |
Transport chair pt wt<=300lb |
438 |
433 |
$3K |
| E0951 |
Loop heel |
222 |
166 |
$3K |
| E0241 |
Bath tub wall rail |
273 |
254 |
$3K |
| E0244 |
Toilet seat raised |
57 |
54 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
151 |
146 |
$1K |
| B4102 |
Ef adult fluids and electro |
14 |
14 |
$1K |
| A6531 |
Compress stking bk30-40 surg |
12 |
12 |
$979.59 |
| A4520 |
Incontinence garment anytype |
1,906 |
1,722 |
$926.51 |
| A4216 |
Sterile water/saline, 10 ml |
43 |
40 |
$458.06 |
| A4450 |
Non-waterproof tape |
16 |
14 |
$93.40 |
| A4217 |
Sterile water/saline, 500 ml |
12 |
12 |
$90.86 |
| A4332 |
Lube sterile packet |
12 |
12 |
$59.40 |