| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads |
21,439 |
20,918 |
$730K |
| T4527 |
Adult size pull-on lg |
5,623 |
5,510 |
$684K |
| T4535 |
Disposable liner/shield/pad |
10,915 |
10,675 |
$404K |
| T4526 |
Adult size pull-on med |
3,914 |
3,856 |
$383K |
| T4528 |
Adult size pull-on xl |
2,539 |
2,491 |
$337K |
| E1399 |
Durable medical equipment mi |
222 |
208 |
$156K |
| A4335 |
Incontinence supply |
25,933 |
25,234 |
$125K |
| T4524 |
Adult size brief/diaper xl |
850 |
835 |
$114K |
| T4534 |
Youth size pull-on |
1,140 |
1,082 |
$103K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,311 |
3,269 |
$92K |
| K0003 |
Lightweight wheelchair |
6,780 |
6,731 |
$91K |
| T4523 |
Adult size brief/diaper lg |
639 |
619 |
$66K |
| T4530 |
Ped size brief/diaper lg |
859 |
814 |
$63K |
| K0001 |
Standard wheelchair |
2,081 |
2,057 |
$56K |
| T4544 |
Adlt disp und/pull on abv xl |
219 |
216 |
$45K |
| T4532 |
Ped size pull-on lg |
377 |
354 |
$40K |
| T4522 |
Adult size brief/diaper med |
458 |
449 |
$38K |
| L4360 |
Pneumat walking boot pre cst |
251 |
242 |
$31K |
| E0240 |
Bath/shower chair |
200 |
197 |
$29K |
| E0630 |
Patient lift hydraulic |
932 |
922 |
$24K |
| E0143 |
Walker folding wheeled w/o s |
949 |
935 |
$19K |
| K0195 |
Elevating whlchair leg rests |
3,845 |
3,814 |
$18K |
| E0163 |
Commode chair with fixed arm |
537 |
535 |
$10K |
| A4670 |
Automatic bp monitor, dial |
148 |
147 |
$9K |
| T4525 |
Adult size pull-on sm |
88 |
88 |
$7K |
| L3908 |
Who cock-up nonmolde pre ots |
193 |
189 |
$6K |
| A4927 |
Non-sterile gloves |
745 |
727 |
$5K |
| B4034 |
Enter feed supkit syr by day |
14 |
12 |
$561.96 |
| E2601 |
Gen w/c cushion wdth < 22 in |
41 |
41 |
$524.39 |
| E0971 |
Wheelchair anti-tipping devi |
40 |
25 |
$326.08 |
| E1020 |
Residual limb support system |
24 |
24 |
$233.21 |
| E0570 |
Nebulizer with compression |
12 |
12 |
$75.00 |
| E1038 |
Transport chair pt wt<=300lb |
87 |
86 |
$37.03 |
| E0935 |
Cont pas motion exercise dev |
12 |
12 |
$0.00 |
| E0156 |
Walker seat attachment |
13 |
12 |
$0.00 |