| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment mi |
7,749 |
5,727 |
$1.78M |
| A4554 |
Disposable underpads |
25,555 |
24,332 |
$1.49M |
| T4527 |
Adult size pull-on lg |
8,919 |
8,521 |
$1.00M |
| T4526 |
Adult size pull-on med |
8,656 |
8,063 |
$782K |
| T4528 |
Adult size pull-on xl |
3,370 |
3,277 |
$399K |
| A4927 |
Non-sterile gloves |
24,881 |
23,650 |
$364K |
| A6250 |
Skin seal protect moisturizr |
21,374 |
17,641 |
$298K |
| E0570 |
Nebulizer with compression |
4,547 |
4,454 |
$227K |
| E0246 |
Transfer tub rail attachment |
2,220 |
2,081 |
$204K |
| A6530 |
Compression stocking bk18-30 |
2,070 |
2,017 |
$172K |
| A4670 |
Automatic bp monitor, dial |
4,406 |
4,179 |
$158K |
| L3216 |
Orthoped ladies shoes dpth i |
1,872 |
1,391 |
$147K |
| L3030 |
Foot arch support remov prem |
2,543 |
1,943 |
$119K |
| E0245 |
Tub stool or bench |
1,959 |
1,823 |
$118K |
| T4524 |
Adult size brief/diaper xl |
922 |
917 |
$100K |
| A7005 |
Nondisposable nebulizer set |
9,797 |
9,669 |
$86K |
| K0001 |
Standard wheelchair |
3,413 |
3,329 |
$77K |
| L1833 |
Ko adj jnt pos r sup pre ots |
282 |
215 |
$71K |
| L3221 |
Orthopedic mens shoes dpth i |
756 |
586 |
$66K |
| E0143 |
Walker folding wheeled w/o s |
2,001 |
1,964 |
$65K |
| T4522 |
Adult size brief/diaper med |
667 |
639 |
$51K |
| A6533 |
Gc stocking thighlngth 18-30 |
370 |
361 |
$49K |
| L3807 |
Whfo w/o joints pre cst |
311 |
246 |
$47K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
221 |
219 |
$35K |
| E0260 |
Hosp bed semi-electr w/ matt |
983 |
966 |
$31K |
| T4525 |
Adult size pull-on sm |
282 |
273 |
$27K |
| E2611 |
Gen use back cush wdth <22in |
445 |
434 |
$24K |
| L1971 |
Afo w/ankle joint, prefab |
102 |
81 |
$23K |
| T4523 |
Adult size brief/diaper lg |
276 |
266 |
$21K |
| E0165 |
Commode chair with detacharm |
297 |
296 |
$18K |
| L3960 |
Sewho airplan desig abdu pos |
48 |
45 |
$17K |
| L0648 |
Lso sag r an/pos pnl pre ots |
79 |
63 |
$16K |
| K0195 |
Elevating whlchair leg rests |
4,099 |
3,961 |
$14K |
| L1820 |
Ko elas w/ condyle pads & jo |
273 |
189 |
$12K |
| T4534 |
Youth size pull-on |
127 |
127 |
$11K |
| A7015 |
Aerosol mask used w nebulize |
9,789 |
9,667 |
$9K |
| L3908 |
Who cock-up nonmolde pre ots |
263 |
206 |
$9K |
| E0445 |
Oximeter non-invasive |
39 |
39 |
$9K |
| K0002 |
Stnd hemi (low seat) whlchr |
176 |
168 |
$8K |
| A6402 |
Sterile gauze <= 16 sq in |
752 |
707 |
$8K |
| E0105 |
Cane adjust/fixed quad/3 pro |
402 |
394 |
$7K |
| L3040 |
Ft arch suprt premold longit |
260 |
235 |
$7K |
| A4362 |
Solid skin barrier |
103 |
103 |
$6K |
| E0181 |
Press pad alternating w/ pum |
716 |
706 |
$6K |
| E0156 |
Walker seat attachment |
1,140 |
1,110 |
$6K |
| L0180 |
Cer post col occ/man sup adj |
35 |
35 |
$6K |
| E2601 |
Gen w/c cushion wdth < 22 in |
423 |
414 |
$5K |
| E0978 |
W/c acc,saf belt pelv strap |
590 |
579 |
$5K |
| K0823 |
Pwc gp 2 std cap chair |
14 |
14 |
$5K |
| E0100 |
Cane adjust/fixed with tip |
608 |
594 |
$5K |
| E0990 |
Wheelchair elevating leg res |
91 |
89 |
$4K |
| L3809 |
Whfo w/o joints pre ots |
58 |
51 |
$3K |
| B4154 |
Ef spec metabolic noninherit |
51 |
49 |
$3K |
| L2397 |
Suspension sleeve lower ext |
70 |
54 |
$2K |
| B4150 |
Ef complet w/intact nutrient |
59 |
58 |
$2K |
| L3217 |
Ladies shoes hightop depth i |
13 |
12 |
$1K |
| L3222 |
Mens shoes hightop depth inl |
14 |
12 |
$1K |
| A4406 |
Pectin based ostomy paste |
117 |
117 |
$1K |
| L3762 |
Eo rigid w/o joints pre ots |
37 |
35 |
$1K |
| A5120 |
Skin barrier, wipe or swab |
192 |
191 |
$1K |
| E0163 |
Commode chair with fixed arm |
74 |
74 |
$1K |
| L0174 |
Cerv sr 2pc thor ext pre ots |
19 |
14 |
$1K |
| E0745 |
Neuromuscular stim for shock |
22 |
12 |
$928.51 |
| E0630 |
Patient lift hydraulic |
12 |
12 |
$416.29 |
| L8000 |
Mastectomy bra |
16 |
12 |
$411.06 |
| A5500 |
Diab shoe for density insert |
19 |
13 |
$308.28 |
| A5512 |
Multi den insert direct form |
19 |
13 |
$285.10 |
| A4371 |
Skin barrier powder per oz |
37 |
37 |
$259.58 |
| A4402 |
Lubricant per ounce |
36 |
36 |
$219.29 |
| A4450 |
Non-waterproof tape |
64 |
64 |
$203.31 |
| A4595 |
Tens suppl 2 lead per month |
47 |
27 |
$200.44 |
| A4557 |
Lead wires, pair |
46 |
26 |
$86.57 |
| A4394 |
Ostomy pouch liq deodorant |
12 |
12 |
$79.06 |