| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
6,133 |
5,589 |
$790K |
| T4541 |
Large disposable underpad |
11,752 |
10,841 |
$599K |
| T4535 |
Disposable liner/shield/pad |
7,970 |
7,345 |
$450K |
| T4528 |
Adult size pull-on xl |
3,914 |
3,521 |
$426K |
| A4927 |
Non-sterile gloves |
19,512 |
17,793 |
$362K |
| T4523 |
Adult size brief/diaper lg |
2,514 |
2,326 |
$291K |
| T4526 |
Adult size pull-on med |
2,380 |
2,183 |
$276K |
| T4543 |
Adult disp brief/diap abv xl |
861 |
762 |
$155K |
| A4670 |
Automatic bp monitor, dial |
2,550 |
2,216 |
$139K |
| T4544 |
Adlt disp und/pull on abv xl |
662 |
560 |
$117K |
| T4524 |
Adult size brief/diaper xl |
956 |
890 |
$113K |
| E0570 |
Nebulizer with compression |
1,379 |
1,266 |
$72K |
| E0245 |
Tub stool or bench |
791 |
707 |
$52K |
| L3908 |
Who cock-up nonmolde pre ots |
883 |
810 |
$49K |
| E0143 |
Walker folding wheeled w/o s |
1,541 |
1,149 |
$45K |
| T4522 |
Adult size brief/diaper med |
494 |
453 |
$41K |
| A6530 |
Compression stocking bk18-30 |
778 |
699 |
$39K |
| A7010 |
Disposable corrugated tubing |
1,465 |
1,310 |
$19K |
| A4663 |
Dialysis blood pressure cuff |
816 |
635 |
$17K |
| A6533 |
Gc stocking thighlngth 18-30 |
181 |
169 |
$14K |
| L1810 |
Ko elastic with joints |
192 |
177 |
$13K |
| E0156 |
Walker seat attachment |
971 |
674 |
$12K |
| E0159 |
Brake for wheeled walker |
1,063 |
736 |
$10K |
| A7016 |
Nebulizer dome & mouthpiece |
1,477 |
1,321 |
$8K |
| E0100 |
Cane adjust/fixed with tip |
331 |
305 |
$4K |
| L8300 |
Truss single w/ standard pad |
67 |
66 |
$4K |
| E0247 |
Trans bench w/wo comm open |
33 |
26 |
$4K |
| A5063 |
Drain ostomy pouch w/flange |
91 |
75 |
$4K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
67 |
52 |
$4K |
| A4450 |
Non-waterproof tape |
548 |
477 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
1,515 |
1,360 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
307 |
270 |
$2K |
| E0163 |
Commode chair with fixed arm |
39 |
38 |
$2K |
| A6219 |
Gauze <= 16 sq in w/border |
107 |
87 |
$1K |
| E0261 |
Hosp bed semi-electr w/o mat |
24 |
24 |
$1K |
| T4525 |
Adult size pull-on sm |
13 |
12 |
$1K |
| K0001 |
Standard wheelchair |
42 |
26 |
$580.01 |
| A4217 |
Sterile water/saline, 500 ml |
110 |
81 |
$416.32 |
| A4357 |
Bedside drainage bag |
29 |
12 |
$305.54 |