| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4522 |
Adult size brief/diaper med |
149,458 |
149,199 |
$6.53M |
| T4535 |
Disposable liner/shield/pad |
218,561 |
217,926 |
$6.25M |
| A4554 |
Disposable underpads |
115,393 |
115,224 |
$3.44M |
| T4523 |
Adult size brief/diaper lg |
47,116 |
47,031 |
$2.91M |
| L3030 |
Foot arch support remov prem |
13,363 |
9,767 |
$1.20M |
| T4537 |
Reusable underpad bed size |
30,060 |
29,995 |
$813K |
| A4927 |
Non-sterile gloves |
132,632 |
132,432 |
$586K |
| B4154 |
Ef spec metabolic noninherit |
5,515 |
5,391 |
$561K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
5,639 |
5,622 |
$554K |
| B4150 |
Ef complet w/intact nutrient |
8,000 |
7,585 |
$523K |
| L3216 |
Orthoped ladies shoes dpth i |
7,921 |
5,840 |
$482K |
| T4524 |
Adult size brief/diaper xl |
6,262 |
6,248 |
$463K |
| A4670 |
Automatic bp monitor, dial |
8,782 |
8,766 |
$427K |
| L3221 |
Orthopedic mens shoes dpth i |
6,028 |
4,355 |
$427K |
| A5500 |
Diab shoe for density insert |
12,984 |
9,976 |
$395K |
| A5512 |
Multi den insert direct form |
12,667 |
9,694 |
$331K |
| T4521 |
Adult size brief/diaper sm |
8,905 |
8,887 |
$330K |
| T4539 |
Reuse diaper/brief any size |
13,285 |
13,218 |
$329K |
| A6530 |
Compression stocking bk18-30 |
7,546 |
7,527 |
$268K |
| E0240 |
Bath/shower chair |
7,553 |
7,527 |
$262K |
| L8030 |
Breast prosthes w/o adhesive |
1,422 |
1,379 |
$196K |
| K0001 |
Standard wheelchair |
21,274 |
21,186 |
$176K |
| L8000 |
Mastectomy bra |
2,314 |
2,221 |
$139K |
| E0143 |
Walker folding wheeled w/o s |
7,133 |
7,090 |
$134K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,360 |
2,145 |
$126K |
| K0002 |
Stnd hemi (low seat) whlchr |
10,461 |
10,406 |
$123K |
| L3002 |
Foot insert plastazote or eq |
646 |
492 |
$108K |
| E0190 |
Positioning cushion |
4,921 |
4,911 |
$98K |
| E2611 |
Gen use back cush wdth <22in |
2,125 |
2,111 |
$93K |
| L1820 |
Ko elas w/ condyle pads & jo |
1,949 |
1,504 |
$84K |
| E0245 |
Tub stool or bench |
3,130 |
3,124 |
$83K |
| A6533 |
Gc stocking thighlngth 18-30 |
1,571 |
1,566 |
$66K |
| E0100 |
Cane adjust/fixed with tip |
11,454 |
11,406 |
$65K |
| L3908 |
Who cock-up nonmolde pre ots |
2,139 |
1,694 |
$64K |
| E0261 |
Hosp bed semi-electr w/o mat |
2,780 |
2,772 |
$63K |
| E0163 |
Commode chair with fixed arm |
2,181 |
2,177 |
$45K |
| E0156 |
Walker seat attachment |
6,766 |
6,731 |
$35K |
| B4034 |
Enter feed supkit syr by day |
1,336 |
893 |
$34K |
| A4335 |
Incontinence supply |
5,177 |
5,173 |
$34K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,628 |
1,614 |
$30K |
| E0241 |
Bath tub wall rail |
906 |
899 |
$30K |
| K0195 |
Elevating whlchair leg rests |
9,852 |
9,779 |
$29K |
| E1399 |
Durable medical equipment mi |
4,096 |
4,083 |
$29K |
| E0570 |
Nebulizer with compression |
4,401 |
4,389 |
$28K |
| E0990 |
Wheelchair elevating leg res |
9,259 |
9,239 |
$27K |
| T4543 |
Adult disp brief/diap abv xl |
158 |
157 |
$25K |
| E2601 |
Gen w/c cushion wdth < 22 in |
2,390 |
2,376 |
$23K |
| E0973 |
W/ch access det adj armrest |
762 |
748 |
$21K |
| E0978 |
W/c acc,saf belt pelv strap |
3,041 |
3,025 |
$20K |
| E0210 |
Electric heat pad standard |
1,795 |
1,788 |
$14K |
| L1902 |
Afo ankle gauntlet pre ots |
376 |
324 |
$11K |
| E0971 |
Wheelchair anti-tipping devi |
715 |
706 |
$10K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
183 |
181 |
$9K |
| A5063 |
Drain ostomy pouch w/flange |
308 |
304 |
$9K |
| B4035 |
Enteral feed supp pump per d |
394 |
180 |
$7K |
| E0105 |
Cane adjust/fixed quad/3 pro |
519 |
518 |
$7K |
| E0961 |
Wheelchair brake extension |
770 |
759 |
$6K |
| A4402 |
Lubricant per ounce |
1,235 |
1,226 |
$6K |
| E1038 |
Transport chair pt wt<=300lb |
1,461 |
1,457 |
$5K |
| T4540 |
Reusable underpad chair size |
277 |
275 |
$3K |
| A4351 |
Straight tip urine catheter |
38 |
38 |
$2K |
| E0215 |
Electric heat pad moist |
255 |
255 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
201 |
201 |
$2K |
| A4357 |
Bedside drainage bag |
168 |
165 |
$2K |
| A4500 |
Below knee surgical stocking |
41 |
41 |
$2K |
| A4660 |
Sphyg/bp app w cuff and stet |
66 |
66 |
$1K |
| E0630 |
Patient lift hydraulic |
105 |
104 |
$1K |
| A4253 |
Blood glucose/reagent strips |
132 |
131 |
$982.32 |
| A6402 |
Sterile gauze <= 16 sq in |
170 |
168 |
$978.01 |
| E0243 |
Toilet rail |
13 |
13 |
$864.69 |
| T4526 |
Adult size pull-on med |
17 |
17 |
$748.80 |
| A5061 |
Pouch drainable w barrier at |
12 |
12 |
$597.88 |
| E0181 |
Press pad alternating w/ pum |
62 |
61 |
$377.20 |
| E0244 |
Toilet seat raised |
14 |
14 |
$263.92 |
| L8300 |
Truss single w/ standard pad |
12 |
12 |
$241.59 |
| L1821 |
Ko elas w/ condyle pads otf |
20 |
12 |
$202.95 |
| A4259 |
Lancets per box |
81 |
80 |
$188.56 |
| E0325 |
Urinal male jug-type |
25 |
25 |
$48.55 |
| A7003 |
Nebulizer administration set |
31 |
25 |
$27.77 |
| A4245 |
Alcohol wipes per box |
13 |
13 |
$19.46 |
| A7015 |
Aerosol mask used w nebulize |
14 |
12 |
$10.12 |