| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4927 |
Non-sterile gloves |
52,033 |
51,792 |
$1.40M |
| T4527 |
Adult size pull-on lg |
14,459 |
14,428 |
$1.35M |
| T4523 |
Adult size brief/diaper lg |
11,082 |
11,027 |
$1.22M |
| T4526 |
Adult size pull-on med |
13,147 |
13,094 |
$1.17M |
| T4541 |
Large disposable underpad |
27,834 |
27,704 |
$1.07M |
| T4528 |
Adult size pull-on xl |
8,850 |
8,817 |
$1.07M |
| T4534 |
Youth size pull-on |
8,060 |
8,016 |
$1.06M |
| T4524 |
Adult size brief/diaper xl |
6,627 |
6,609 |
$875K |
| B4150 |
Ef complet w/intact nutrient |
5,996 |
5,939 |
$822K |
| T4522 |
Adult size brief/diaper med |
8,861 |
8,826 |
$776K |
| T4535 |
Disposable liner/shield/pad |
10,155 |
10,098 |
$503K |
| K0108 |
W/c component-accessory nos |
1,751 |
819 |
$417K |
| T4537 |
Reusable underpad bed size |
19,937 |
19,897 |
$323K |
| B4100 |
Food thickener oral |
5,653 |
5,634 |
$294K |
| T4530 |
Ped size brief/diaper lg |
2,079 |
2,067 |
$264K |
| A4351 |
Straight tip urine catheter |
1,640 |
1,613 |
$217K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,612 |
4,561 |
$197K |
| K0001 |
Standard wheelchair |
6,638 |
6,570 |
$138K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,913 |
1,756 |
$132K |
| B4152 |
Ef calorie dense>/=1.5kcal |
939 |
931 |
$122K |
| E1399 |
Durable medical equipment mi |
253 |
160 |
$102K |
| E0245 |
Tub stool or bench |
2,081 |
2,076 |
$85K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
677 |
668 |
$79K |
| E0630 |
Patient lift hydraulic |
1,858 |
1,834 |
$55K |
| E0143 |
Walker folding wheeled w/o s |
1,205 |
1,199 |
$51K |
| A5131 |
Appliance cleaner |
3,573 |
3,551 |
$49K |
| T4544 |
Adlt disp und/pull on abv xl |
225 |
222 |
$48K |
| A9901 |
Delivery/set up/dispensing |
16,621 |
16,492 |
$46K |
| K0823 |
Pwc gp 2 std cap chair |
213 |
200 |
$45K |
| T4521 |
Adult size brief/diaper sm |
296 |
295 |
$38K |
| K0006 |
Heavy duty wheelchair |
643 |
643 |
$33K |
| E1028 |
W/c manual swingaway |
361 |
259 |
$33K |
| K0195 |
Elevating whlchair leg rests |
4,596 |
4,542 |
$32K |
| B4154 |
Ef spec metabolic noninherit |
264 |
261 |
$29K |
| A4670 |
Automatic bp monitor, dial |
504 |
504 |
$27K |
| K0002 |
Stnd hemi (low seat) whlchr |
849 |
845 |
$20K |
| E0570 |
Nebulizer with compression |
348 |
348 |
$19K |
| E0241 |
Bath tub wall rail |
382 |
359 |
$16K |
| E0265 |
Hosp bed total electr w/ mat |
357 |
345 |
$15K |
| E0973 |
W/ch access det adj armrest |
363 |
292 |
$15K |
| E0244 |
Toilet seat raised |
282 |
280 |
$13K |
| E0163 |
Commode chair with fixed arm |
308 |
306 |
$12K |
| E0971 |
Wheelchair anti-tipping devi |
868 |
662 |
$10K |
| A4357 |
Bedside drainage bag |
1,100 |
1,080 |
$6K |
| E0955 |
Cushioned headrest |
55 |
52 |
$4K |
| E0147 |
Walker variable wheel resist |
48 |
48 |
$4K |
| E1038 |
Transport chair pt wt<=300lb |
468 |
465 |
$3K |
| A4358 |
Urinary leg or abdomen bag |
595 |
579 |
$3K |
| E1226 |
Manual fully reclining back |
13 |
12 |
$881.01 |
| E0978 |
W/c acc,saf belt pelv strap |
32 |
31 |
$845.40 |
| K0003 |
Lightweight wheelchair |
12 |
12 |
$730.75 |
| E0247 |
Trans bench w/wo comm open |
16 |
16 |
$584.45 |
| E0118 |
Crutch substitute |
12 |
12 |
$526.29 |
| A4354 |
Cath insertion tray w/bag |
37 |
37 |
$192.82 |
| E0156 |
Walker seat attachment |
12 |
12 |
$170.34 |
| A4402 |
Lubricant per ounce |
39 |
38 |
$143.29 |
| E0100 |
Cane adjust/fixed with tip |
12 |
12 |
$109.76 |
| K0019 |
Arm pad repl, each |
12 |
12 |
$102.41 |
| A4217 |
Sterile water/saline, 500 ml |
13 |
13 |
$37.19 |
| A4338 |
Indwelling catheter latex |
15 |
14 |
$23.36 |