| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
1,648 |
1,520 |
$171K |
| T2029 |
Special med equip, noswaiver |
1,200 |
1,047 |
$167K |
| T4528 |
Adult size pull-on xl |
1,152 |
1,056 |
$141K |
| T4535 |
Disposable liner/shield/pad |
1,884 |
1,702 |
$135K |
| T4526 |
Adult size pull-on med |
1,046 |
991 |
$99K |
| T4523 |
Adult size brief/diaper lg |
361 |
343 |
$69K |
| E0260 |
Hosp bed semi-electr w/ matt |
700 |
690 |
$47K |
| T4541 |
Large disposable underpad |
966 |
938 |
$41K |
| T4544 |
Adlt disp und/pull on abv xl |
204 |
198 |
$40K |
| K0001 |
Standard wheelchair |
1,400 |
1,372 |
$37K |
| A4927 |
Non-sterile gloves |
923 |
898 |
$33K |
| B4150 |
Ef complet w/intact nutrient |
216 |
182 |
$27K |
| T4522 |
Adult size brief/diaper med |
159 |
150 |
$27K |
| E0601 |
Cont airway pressure device |
537 |
529 |
$26K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
354 |
349 |
$10K |
| T4534 |
Youth size pull-on |
71 |
69 |
$9K |
| E0562 |
Humidifier heated used w pap |
438 |
431 |
$8K |
| E0570 |
Nebulizer with compression |
493 |
491 |
$8K |
| A4351 |
Straight tip urine catheter |
26 |
24 |
$7K |
| A4604 |
Tubing with heating element |
123 |
119 |
$7K |
| B9998 |
Enteral supp not otherwise c |
114 |
48 |
$6K |
| A4520 |
Incontinence garment anytype |
123 |
94 |
$6K |
| A4322 |
Irrigation syringe |
31 |
24 |
$3K |
| A7035 |
Pos airway press headgear |
130 |
128 |
$3K |
| A7038 |
Pos airway pressure filter |
494 |
484 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
39 |
36 |
$2K |
| A7033 |
Replacement nasal pillows |
57 |
57 |
$2K |
| A7030 |
Cpap full face mask |
12 |
12 |
$1K |
| T4525 |
Adult size pull-on sm |
12 |
12 |
$1K |
| A7031 |
Replacement facemask interfa |
33 |
31 |
$1K |
| E0630 |
Patient lift hydraulic |
24 |
24 |
$927.74 |
| A7005 |
Nondisposable nebulizer set |
26 |
26 |
$495.11 |
| A4358 |
Urinary leg or abdomen bag |
31 |
24 |
$438.73 |
| A7003 |
Nebulizer administration set |
24 |
24 |
$93.26 |
| A7013 |
Disposable compressor filter |
28 |
27 |
$20.77 |