| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
4,790 |
4,547 |
$229K |
| T4535 |
Disposable liner/shield/pad |
2,517 |
2,383 |
$169K |
| T4528 |
Adult size pull-on xl |
1,275 |
1,211 |
$163K |
| T4527 |
Adult size pull-on lg |
1,096 |
1,051 |
$146K |
| T4526 |
Adult size pull-on med |
1,037 |
998 |
$146K |
| A4927 |
Non-sterile gloves |
5,663 |
5,338 |
$132K |
| E1028 |
W/c manual swingaway |
2,356 |
1,716 |
$130K |
| T4523 |
Adult size brief/diaper lg |
775 |
711 |
$89K |
| A6197 |
Alginate drsg >16 <=48 sq in |
347 |
318 |
$71K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
228 |
202 |
$61K |
| E0181 |
Press pad alternating w/ pum |
2,775 |
2,602 |
$35K |
| A9276 |
Disposable sensor, cgm sys |
36 |
27 |
$34K |
| A4452 |
Waterproof tape |
850 |
769 |
$33K |
| E0255 |
Hospital bed var ht w/ mattr |
4,446 |
4,161 |
$31K |
| E1161 |
Manual adult wc w tiltinspac |
502 |
458 |
$30K |
| A4553 |
Nondisp underpads, all sizes |
1,885 |
1,782 |
$27K |
| K0823 |
Pwc gp 2 std cap chair |
657 |
602 |
$26K |
| K0195 |
Elevating whlchair leg rests |
1,868 |
1,751 |
$24K |
| A6212 |
Foam drg <=16 sq in w/border |
121 |
106 |
$22K |
| E0630 |
Patient lift hydraulic |
1,460 |
1,380 |
$21K |
| K0003 |
Lightweight wheelchair |
745 |
742 |
$19K |
| A5120 |
Skin barrier, wipe or swab |
1,319 |
1,205 |
$19K |
| E0265 |
Hosp bed total electr w/ mat |
2,481 |
2,345 |
$13K |
| A4456 |
Adhesive remover, wipes |
645 |
590 |
$12K |
| K0002 |
Stnd hemi (low seat) whlchr |
1,177 |
1,137 |
$12K |
| T4524 |
Adult size brief/diaper xl |
76 |
75 |
$11K |
| A6446 |
Conform band s w>=3" <5"/yd |
291 |
269 |
$8K |
| A6216 |
Non-sterile gauze<=16 sq in |
1,086 |
994 |
$8K |
| A6402 |
Sterile gauze <= 16 sq in |
271 |
244 |
$6K |
| K0001 |
Standard wheelchair |
1,642 |
1,525 |
$5K |
| E0955 |
Cushioned headrest |
541 |
515 |
$5K |
| A4239 |
Non-adju cgm supply allow |
38 |
38 |
$5K |
| A4357 |
Bedside drainage bag |
224 |
213 |
$5K |
| E0570 |
Nebulizer with compression |
1,482 |
1,417 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
245 |
245 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
226 |
211 |
$4K |
| A4385 |
Ost skn barrier sld ext wear |
83 |
77 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
151 |
139 |
$3K |
| A6021 |
Collagen dressing <=16 sq in |
14 |
13 |
$3K |
| E0163 |
Commode chair with fixed arm |
143 |
139 |
$3K |
| E0973 |
W/ch access det adj armrest |
94 |
53 |
$3K |
| E0277 |
Powered pres-redu air mattrs |
295 |
286 |
$2K |
| T4525 |
Adult size pull-on sm |
12 |
12 |
$2K |
| A4362 |
Solid skin barrier |
40 |
37 |
$1K |
| A4394 |
Ostomy pouch liq deodorant |
25 |
24 |
$1K |
| T4522 |
Adult size brief/diaper med |
12 |
12 |
$982.80 |
| E0971 |
Wheelchair anti-tipping devi |
25 |
14 |
$804.66 |
| A6219 |
Gauze <= 16 sq in w/border |
43 |
40 |
$761.68 |
| E0247 |
Trans bench w/wo comm open |
12 |
12 |
$685.41 |
| A4450 |
Non-waterproof tape |
67 |
63 |
$614.74 |
| A6443 |
Conform band n/s w>=3"<5"/yd |
57 |
52 |
$569.47 |
| A4371 |
Skin barrier powder per oz |
56 |
52 |
$569.31 |
| E2611 |
Gen use back cush wdth <22in |
13 |
13 |
$454.80 |
| A4358 |
Urinary leg or abdomen bag |
13 |
12 |
$384.20 |
| E0165 |
Commode chair with detacharm |
24 |
24 |
$376.15 |
| E1038 |
Transport chair pt wt<=300lb |
148 |
142 |
$374.93 |
| E0256 |
Hospital bed var ht w/o matt |
12 |
12 |
$149.08 |
| E0910 |
Trapeze bar attached to bed |
24 |
24 |
$134.64 |
| E0250 |
Hosp bed fixed ht w/ mattres |
191 |
190 |
$0.00 |