| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
90,455 |
90,123 |
$7.35M |
| A4554 |
Disposable underpads |
174,420 |
173,486 |
$7.17M |
| T4524 |
Adult size brief/diaper xl |
51,509 |
51,283 |
$4.63M |
| T4535 |
Disposable liner/shield/pad |
140,426 |
139,818 |
$4.35M |
| T4522 |
Adult size brief/diaper med |
73,399 |
73,097 |
$4.26M |
| T4543 |
Adult disp brief/diap abv xl |
17,191 |
17,115 |
$2.98M |
| T4537 |
Reusable underpad bed size |
56,192 |
55,648 |
$1.68M |
| K0739 |
Repair/svc dme non-oxygen eq |
13,987 |
13,750 |
$872K |
| T4521 |
Adult size brief/diaper sm |
12,509 |
12,461 |
$673K |
| B4150 |
Ef complet w/intact nutrient |
8,364 |
8,287 |
$667K |
| A5120 |
Skin barrier, wipe or swab |
32,083 |
30,373 |
$609K |
| B4154 |
Ef spec metabolic noninherit |
3,794 |
3,759 |
$496K |
| T4539 |
Reuse diaper/brief any size |
17,810 |
17,445 |
$482K |
| A4927 |
Non-sterile gloves |
84,168 |
83,719 |
$374K |
| E0241 |
Bath tub wall rail |
13,938 |
13,893 |
$361K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,403 |
2,361 |
$235K |
| E1399 |
Durable medical equipment mi |
2,675 |
2,474 |
$216K |
| E0240 |
Bath/shower chair |
5,816 |
5,791 |
$189K |
| A4335 |
Incontinence supply |
5,356 |
5,140 |
$143K |
| A4670 |
Automatic bp monitor, dial |
2,654 |
2,644 |
$120K |
| A4253 |
Blood glucose/reagent strips |
4,587 |
4,500 |
$115K |
| A4402 |
Lubricant per ounce |
16,840 |
15,327 |
$100K |
| T4540 |
Reusable underpad chair size |
6,589 |
6,556 |
$96K |
| E0243 |
Toilet rail |
1,372 |
1,364 |
$82K |
| E0143 |
Walker folding wheeled w/o s |
851 |
851 |
$46K |
| K0001 |
Standard wheelchair |
1,640 |
1,634 |
$45K |
| T4527 |
Adult size pull-on lg |
859 |
856 |
$43K |
| T4526 |
Adult size pull-on med |
788 |
786 |
$36K |
| E0244 |
Toilet seat raised |
1,758 |
1,751 |
$32K |
| A4259 |
Lancets per box |
4,390 |
4,342 |
$27K |
| T4528 |
Adult size pull-on xl |
464 |
459 |
$27K |
| E0247 |
Trans bench w/wo comm open |
334 |
333 |
$27K |
| T4541 |
Large disposable underpad |
557 |
554 |
$26K |
| A6250 |
Skin seal protect moisturizr |
2,282 |
2,274 |
$25K |
| A4239 |
Non-adju cgm supply allow |
121 |
118 |
$19K |
| K0003 |
Lightweight wheelchair |
503 |
501 |
$12K |
| E0156 |
Walker seat attachment |
792 |
785 |
$11K |
| T4525 |
Adult size pull-on sm |
143 |
142 |
$8K |
| E0163 |
Commode chair with fixed arm |
132 |
132 |
$8K |
| E0607 |
Blood glucose monitor home |
143 |
131 |
$7K |
| A4245 |
Alcohol wipes per box |
4,310 |
4,274 |
$7K |
| A6402 |
Sterile gauze <= 16 sq in |
547 |
515 |
$7K |
| E0260 |
Hosp bed semi-electr w/ matt |
252 |
251 |
$4K |
| B4100 |
Food thickener oral |
83 |
83 |
$3K |
| A4357 |
Bedside drainage bag |
76 |
75 |
$3K |
| K0195 |
Elevating whlchair leg rests |
1,009 |
1,008 |
$2K |
| K0553 |
Ther cgm supply allowance |
15 |
13 |
$2K |
| E0246 |
Transfer tub rail attachment |
25 |
25 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
25 |
25 |
$968.85 |
| E0973 |
W/ch access det adj armrest |
14 |
13 |
$859.33 |
| E0261 |
Hosp bed semi-electr w/o mat |
12 |
12 |
$845.22 |
| E0570 |
Nebulizer with compression |
27 |
27 |
$498.43 |
| E0971 |
Wheelchair anti-tipping devi |
12 |
12 |
$497.60 |
| E2601 |
Gen w/c cushion wdth < 22 in |
12 |
12 |
$349.71 |
| V5266 |
Battery for hearing device |
26 |
24 |
$334.06 |
| E0100 |
Cane adjust/fixed with tip |
36 |
36 |
$312.19 |