| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Straight tip urine catheter |
38,414 |
35,848 |
$22.33M |
| T4541 |
Large disposable underpad |
65,294 |
63,750 |
$3.86M |
| K0108 |
W/c component-accessory nos |
20,270 |
5,387 |
$2.64M |
| A4927 |
Non-sterile gloves |
53,832 |
51,045 |
$1.26M |
| T4523 |
Adult size brief/diaper lg |
14,561 |
14,328 |
$1.26M |
| A4353 |
Intermittent urinary cath |
2,008 |
1,937 |
$1.10M |
| A4352 |
Coude tip urinary catheter |
1,914 |
1,873 |
$930K |
| A4409 |
Ost skn barr convex <=4 sq i |
3,887 |
3,645 |
$786K |
| T4524 |
Adult size brief/diaper xl |
7,505 |
7,311 |
$682K |
| T4535 |
Disposable liner/shield/pad |
12,916 |
11,903 |
$654K |
| T4527 |
Adult size pull-on lg |
8,113 |
8,025 |
$611K |
| K0739 |
Repair/svc dme non-oxygen eq |
5,081 |
4,846 |
$583K |
| E1399 |
Durable medical equipment mi |
1,428 |
1,144 |
$563K |
| A4349 |
Disposable male external cat |
9,672 |
9,010 |
$465K |
| T4522 |
Adult size brief/diaper med |
6,064 |
5,929 |
$451K |
| T4526 |
Adult size pull-on med |
7,557 |
7,460 |
$447K |
| K0001 |
Standard wheelchair |
5,628 |
5,302 |
$418K |
| E0295 |
Hosp bed semi-elect w/o matt |
2,248 |
2,138 |
$379K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
3,013 |
2,558 |
$379K |
| T4528 |
Adult size pull-on xl |
4,888 |
4,793 |
$373K |
| A4425 |
Ost pch drain for barrier fl |
3,501 |
3,125 |
$343K |
| E1390 |
Oxygen concentrator |
2,241 |
2,184 |
$304K |
| A6446 |
Conform band s w>=3" <5"/yd |
4,619 |
4,474 |
$248K |
| E0240 |
Bath/shower chair |
167 |
159 |
$225K |
| A4357 |
Bedside drainage bag |
12,096 |
10,711 |
$225K |
| T5999 |
Supply, nos |
759 |
714 |
$216K |
| A5063 |
Drain ostomy pouch w/flange |
2,694 |
2,335 |
$199K |
| A4402 |
Lubricant per ounce |
31,138 |
29,700 |
$192K |
| A5061 |
Pouch drainable w barrier at |
1,845 |
1,532 |
$192K |
| A5112 |
Urinary leg bag |
5,160 |
4,458 |
$174K |
| E0630 |
Patient lift hydraulic |
1,150 |
1,077 |
$148K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
1,553 |
1,499 |
$146K |
| E0971 |
Wheelchair anti-tipping devi |
10,409 |
6,205 |
$140K |
| A4358 |
Urinary leg or abdomen bag |
7,513 |
6,609 |
$111K |
| E0143 |
Walker folding wheeled w/o s |
2,357 |
2,309 |
$111K |
| A6250 |
Skin seal protect moisturizr |
7,231 |
7,125 |
$103K |
| A4520 |
Incontinence garment anytype |
1,988 |
1,858 |
$93K |
| A6216 |
Non-sterile gauze<=16 sq in |
7,342 |
7,051 |
$87K |
| E0245 |
Tub stool or bench |
1,449 |
1,396 |
$80K |
| A6212 |
Foam drg <=16 sq in w/border |
714 |
681 |
$73K |
| A4335 |
Incontinence supply |
7,525 |
7,376 |
$73K |
| T4525 |
Adult size pull-on sm |
1,284 |
1,273 |
$70K |
| A4554 |
Disposable underpads |
1,313 |
1,276 |
$62K |
| A4320 |
Irrigation tray |
2,742 |
2,550 |
$54K |
| A4624 |
Tracheal suction tube |
572 |
507 |
$53K |
| E0247 |
Trans bench w/wo comm open |
639 |
628 |
$51K |
| T4537 |
Reusable underpad bed size |
1,525 |
1,513 |
$50K |
| E0431 |
Portable gaseous 02 |
2,107 |
2,090 |
$49K |
| A4432 |
Os pch urine w bar/fange/tap |
515 |
441 |
$45K |
| E0973 |
W/ch access det adj armrest |
298 |
241 |
$44K |
| A4456 |
Adhesive remover, wipes |
3,988 |
3,883 |
$44K |
| A5120 |
Skin barrier, wipe or swab |
5,168 |
4,909 |
$43K |
| A4670 |
Automatic bp monitor, dial |
833 |
828 |
$42K |
| K0005 |
Ultralightweight wheelchair |
25 |
25 |
$42K |
| E0978 |
W/c acc,saf belt pelv strap |
2,344 |
2,205 |
$41K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
2,028 |
1,964 |
$38K |
| E2386 |
Foam filled drive wheel tire |
141 |
138 |
$38K |
| A4364 |
Adhesive, liquid or equal |
1,585 |
1,512 |
$34K |
| E0272 |
Mattress foam rubber |
575 |
573 |
$33K |
| E0305 |
Rails bed side half length |
1,083 |
1,031 |
$31K |
| E2617 |
Custom fab w/c back cushion |
26 |
26 |
$28K |
| A4406 |
Pectin based ostomy paste |
2,082 |
1,937 |
$27K |
| E2622 |
Adj skin pro w/c cus wd<22in |
88 |
88 |
$25K |
| E0570 |
Nebulizer with compression |
676 |
665 |
$23K |
| A6402 |
Sterile gauze <= 16 sq in |
2,219 |
2,101 |
$21K |
| A7526 |
Tracheostomy tube collar |
298 |
290 |
$20K |
| A4310 |
Insert tray w/o bag/cath |
1,212 |
1,070 |
$19K |
| A7520 |
Trach/laryn tube non-cuffed |
219 |
209 |
$19K |
| A5056 |
1 pc ost pouch w filter |
112 |
110 |
$18K |
| E0156 |
Walker seat attachment |
1,398 |
1,385 |
$17K |
| A5131 |
Appliance cleaner |
1,665 |
1,587 |
$16K |
| K0040 |
Adjustable angle footplate |
139 |
110 |
$16K |
| A4331 |
Extension drainage tubing |
2,671 |
2,541 |
$16K |
| E1028 |
W/c manual swingaway |
102 |
48 |
$16K |
| E2394 |
Drive wheel excludes tire |
100 |
99 |
$14K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
174 |
170 |
$13K |
| A4338 |
Indwelling catheter latex |
469 |
410 |
$13K |
| E0720 |
Tens two lead |
82 |
82 |
$12K |
| A4333 |
Urinary cath anchor device |
678 |
642 |
$12K |
| A4629 |
Tracheostomy care kit |
214 |
205 |
$11K |
| E2609 |
Custom fabricate w/c cushion |
14 |
12 |
$10K |
| E2392 |
Solid caster tire, integrate |
62 |
60 |
$10K |
| A4314 |
Cath w/drainage 2-way latex |
307 |
285 |
$9K |
| A4344 |
Cath indw foley 2 way silicn |
273 |
235 |
$9K |
| A5114 |
Foam/fabric leg strap |
772 |
719 |
$9K |
| K0195 |
Elevating whlchair leg rests |
344 |
335 |
$9K |
| A4385 |
Ost skn barrier sld ext wear |
64 |
62 |
$8K |
| E0163 |
Commode chair with fixed arm |
143 |
127 |
$8K |
| A4362 |
Solid skin barrier |
74 |
64 |
$6K |
| E1038 |
Transport chair pt wt<=300lb |
379 |
349 |
$5K |
| A4394 |
Ostomy pouch liq deodorant |
262 |
254 |
$5K |
| A7000 |
Disposable canister for pump |
462 |
450 |
$5K |
| E0310 |
Rails bed side full length |
299 |
294 |
$4K |
| E0181 |
Press pad alternating w/ pum |
126 |
92 |
$4K |
| E2624 |
Adj skin pro/pos cus<22in |
14 |
12 |
$3K |
| A4371 |
Skin barrier powder per oz |
343 |
331 |
$3K |
| E2361 |
22nf sealed leadacid battery |
12 |
12 |
$3K |
| E0165 |
Commode chair with detacharm |
14 |
13 |
$2K |
| A4424 |
Ost pch drain w bar & filter |
13 |
12 |
$2K |
| A4247 |
Betadine/iodine swabs/wipes |
70 |
68 |
$2K |
| E0443 |
Portable 02 contents, gas |
15 |
12 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
61 |
61 |
$2K |
| A4450 |
Non-waterproof tape |
800 |
779 |
$1K |
| A6240 |
Hydrocolld drg filler paste |
25 |
25 |
$1K |
| A4322 |
Irrigation syringe |
38 |
36 |
$924.23 |
| E0955 |
Cushioned headrest |
12 |
12 |
$921.78 |
| E0105 |
Cane adjust/fixed quad/3 pro |
35 |
30 |
$859.71 |
| E2212 |
Pneumatic prop tire tube |
64 |
64 |
$722.60 |
| A6253 |
Absorpt drg > 48 sq in w/o b |
32 |
26 |
$640.29 |
| E0100 |
Cane adjust/fixed with tip |
46 |
44 |
$569.40 |
| A4311 |
Catheter w/o bag 2-way latex |
12 |
12 |
$387.04 |
| E0241 |
Bath tub wall rail |
14 |
14 |
$321.88 |
| K0019 |
Arm pad repl, each |
13 |
13 |
$316.02 |
| A6407 |
Packing strips, non-impreg |
14 |
13 |
$189.95 |