| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
30,062 |
28,617 |
$3.61M |
| T4527 |
Adult size pull-on lg |
39,526 |
39,191 |
$3.50M |
| A4554 |
Disposable underpads |
117,165 |
115,856 |
$2.85M |
| T4528 |
Adult size pull-on xl |
23,530 |
23,275 |
$2.72M |
| T4526 |
Adult size pull-on med |
31,746 |
31,444 |
$2.23M |
| E1399 |
Durable medical equipment mi |
24,257 |
10,988 |
$1.95M |
| T4535 |
Disposable liner/shield/pad |
64,127 |
63,370 |
$1.80M |
| T4544 |
Adlt disp und/pull on abv xl |
7,135 |
7,071 |
$1.04M |
| T2028 |
Special supply, nos waiver |
11,885 |
11,850 |
$928K |
| A4335 |
Incontinence supply |
158,482 |
155,765 |
$839K |
| B4150 |
Ef complet w/intact nutrient |
5,202 |
4,216 |
$486K |
| B4154 |
Ef spec metabolic noninherit |
1,382 |
1,104 |
$344K |
| T4543 |
Adult disp brief/diap abv xl |
2,896 |
2,853 |
$339K |
| T4523 |
Adult size brief/diaper lg |
4,249 |
4,179 |
$303K |
| T4522 |
Adult size brief/diaper med |
4,025 |
3,955 |
$288K |
| T4524 |
Adult size brief/diaper xl |
3,005 |
2,989 |
$288K |
| A4253 |
Blood glucose/reagent strips |
9,598 |
8,933 |
$263K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,152 |
992 |
$228K |
| A4670 |
Automatic bp monitor, dial |
3,789 |
3,708 |
$207K |
| T4525 |
Adult size pull-on sm |
3,049 |
3,012 |
$180K |
| A4351 |
Straight tip urine catheter |
981 |
911 |
$164K |
| T4534 |
Youth size pull-on |
2,182 |
2,123 |
$148K |
| T2029 |
Special med equip, noswaiver |
1,724 |
1,724 |
$129K |
| E0240 |
Bath/shower chair |
1,579 |
1,536 |
$120K |
| T4532 |
Ped size pull-on lg |
1,135 |
1,098 |
$75K |
| B9998 |
Enteral supp not otherwise c |
569 |
415 |
$63K |
| E0143 |
Walker folding wheeled w/o s |
1,414 |
1,376 |
$59K |
| A4259 |
Lancets per box |
7,013 |
6,785 |
$54K |
| S5199 |
Personal care item nos each |
727 |
539 |
$49K |
| B4034 |
Enter feed supkit syr by day |
407 |
394 |
$41K |
| E0247 |
Trans bench w/wo comm open |
466 |
454 |
$35K |
| T4521 |
Adult size brief/diaper sm |
401 |
393 |
$24K |
| E0246 |
Transfer tub rail attachment |
386 |
374 |
$16K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
210 |
201 |
$13K |
| T1999 |
Noc retail items andsupplies |
114 |
111 |
$13K |
| A4353 |
Intermittent urinary cath |
24 |
24 |
$12K |
| T4533 |
Youth size brief/diaper |
152 |
135 |
$9K |
| A6402 |
Sterile gauze <= 16 sq in |
606 |
545 |
$9K |
| A4245 |
Alcohol wipes per box |
6,387 |
6,287 |
$9K |
| A6250 |
Skin seal protect moisturizr |
1,114 |
1,086 |
$7K |
| A4314 |
Cath w/drainage 2-way latex |
257 |
244 |
$6K |
| A4349 |
Disposable male external cat |
189 |
179 |
$6K |
| A4357 |
Bedside drainage bag |
676 |
610 |
$5K |
| A5063 |
Drain ostomy pouch w/flange |
132 |
131 |
$5K |
| A5120 |
Skin barrier, wipe or swab |
535 |
513 |
$5K |
| A4394 |
Ostomy pouch liq deodorant |
292 |
265 |
$4K |
| A4456 |
Adhesive remover, wipes |
399 |
378 |
$4K |
| A4927 |
Non-sterile gloves |
347 |
333 |
$4K |
| E0570 |
Nebulizer with compression |
42 |
42 |
$4K |
| A4358 |
Urinary leg or abdomen bag |
504 |
473 |
$4K |
| A7003 |
Nebulizer administration set |
1,565 |
1,536 |
$3K |
| E0105 |
Cane adjust/fixed quad/3 pro |
142 |
139 |
$3K |
| A4402 |
Lubricant per ounce |
629 |
577 |
$3K |
| E0244 |
Toilet seat raised |
97 |
96 |
$3K |
| T4537 |
Reusable underpad bed size |
91 |
86 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
171 |
165 |
$2K |
| E0163 |
Commode chair with fixed arm |
20 |
17 |
$958.37 |
| A4406 |
Pectin based ostomy paste |
56 |
54 |
$938.47 |
| E0602 |
Manual breast pump |
12 |
12 |
$376.80 |
| A4322 |
Irrigation syringe |
12 |
12 |
$282.25 |
| A4371 |
Skin barrier powder per oz |
13 |
12 |
$43.19 |