| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0240 |
Bath/shower chair |
6,112 |
4,671 |
$1.70M |
| A4554 |
Disposable underpads |
29,745 |
26,675 |
$1.26M |
| L0650 |
Lso sc r ant/pos pnl pre ots |
1,743 |
1,423 |
$1.22M |
| T4527 |
Adult size pull-on lg |
13,075 |
11,782 |
$1.06M |
| T4535 |
Disposable liner/shield/pad |
17,204 |
15,445 |
$1.06M |
| T4528 |
Adult size pull-on xl |
11,487 |
10,258 |
$784K |
| T4526 |
Adult size pull-on med |
9,584 |
8,638 |
$710K |
| A4927 |
Non-sterile gloves |
30,987 |
27,280 |
$336K |
| E0246 |
Transfer tub rail attachment |
6,410 |
2,785 |
$322K |
| T4544 |
Adlt disp und/pull on abv xl |
4,484 |
4,100 |
$309K |
| A4253 |
Blood glucose/reagent strips |
4,153 |
2,716 |
$275K |
| T4532 |
Ped size pull-on lg |
1,360 |
1,274 |
$152K |
| L0631 |
Lso sag r an/pos pnl pre cst |
245 |
168 |
$147K |
| E0143 |
Walker folding wheeled w/o s |
2,434 |
2,045 |
$126K |
| K0823 |
Pwc gp 2 std cap chair |
3,999 |
3,502 |
$124K |
| T4525 |
Adult size pull-on sm |
2,413 |
2,211 |
$123K |
| K0011 |
Stnd wt pwr whlchr w control |
23 |
13 |
$93K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,035 |
2,661 |
$91K |
| E0114 |
Crutch underarm pair no wood |
2,570 |
1,793 |
$87K |
| L0637 |
Lso sc r ant/pos pnl pre cst |
92 |
85 |
$81K |
| L3660 |
So 8 ab rstr can/web pre ots |
1,295 |
926 |
$64K |
| E0241 |
Bath tub wall rail |
2,632 |
1,890 |
$55K |
| L3916 |
Who nontorsion jnts pre ots |
189 |
148 |
$50K |
| L4361 |
Pneuma/vac walk boot pre ots |
414 |
267 |
$50K |
| E1390 |
Oxygen concentrator |
3,515 |
3,048 |
$49K |
| E1028 |
W/c manual swingaway |
477 |
370 |
$45K |
| A4259 |
Lancets per box |
4,243 |
2,705 |
$43K |
| B4035 |
Enteral feed supp pump per d |
464 |
363 |
$41K |
| T4523 |
Adult size brief/diaper lg |
588 |
510 |
$38K |
| T4524 |
Adult size brief/diaper xl |
581 |
493 |
$31K |
| E2365 |
U1 sealed leadacid battery |
320 |
266 |
$31K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
286 |
197 |
$31K |
| E0163 |
Commode chair with fixed arm |
889 |
717 |
$31K |
| E0607 |
Blood glucose monitor home |
594 |
373 |
$29K |
| T4521 |
Adult size brief/diaper sm |
459 |
406 |
$28K |
| E2361 |
22nf sealed leadacid battery |
151 |
127 |
$28K |
| L1833 |
Ko adj jnt pos r sup pre ots |
83 |
56 |
$27K |
| K0825 |
Pwc gp 2 hd cap chair |
644 |
582 |
$23K |
| L3809 |
Whfo w/o joints pre ots |
194 |
129 |
$21K |
| T4543 |
Adult disp brief/diap abv xl |
349 |
314 |
$19K |
| B9002 |
Enter nutr inf pump any type |
692 |
452 |
$19K |
| K0001 |
Standard wheelchair |
2,645 |
2,458 |
$18K |
| E0630 |
Patient lift hydraulic |
979 |
870 |
$16K |
| T4522 |
Adult size brief/diaper med |
202 |
180 |
$12K |
| K0003 |
Lightweight wheelchair |
1,161 |
1,049 |
$9K |
| E0935 |
Cont pas motion exercise dev |
52 |
50 |
$7K |
| L4387 |
Non-pneum walk boot pre ots |
52 |
39 |
$5K |
| E0247 |
Trans bench w/wo comm open |
62 |
51 |
$5K |
| B9998 |
Enteral supp not otherwise c |
313 |
246 |
$5K |
| E0156 |
Walker seat attachment |
607 |
504 |
$4K |
| E1392 |
Portable oxygen concentrator |
3,011 |
2,718 |
$4K |
| E0973 |
W/ch access det adj armrest |
158 |
109 |
$4K |
| E0430 |
Oxygen system gas portable |
165 |
112 |
$4K |
| L1830 |
Ko immob canvas long pre ots |
93 |
65 |
$4K |
| L3908 |
Who cock-up nonmolde pre ots |
120 |
95 |
$4K |
| E0149 |
Heavy duty wheeled walker |
179 |
169 |
$3K |
| E0955 |
Cushioned headrest |
18 |
13 |
$2K |
| L3670 |
So acro/clav can web pre ots |
19 |
17 |
$1K |
| E2601 |
Gen w/c cushion wdth < 22 in |
73 |
66 |
$943.10 |
| E2611 |
Gen use back cush wdth <22in |
74 |
67 |
$839.19 |
| K0739 |
Repair/svc dme non-oxygen eq |
104 |
101 |
$321.22 |
| E0570 |
Nebulizer with compression |
127 |
124 |
$250.92 |
| E0910 |
Trapeze bar attached to bed |
289 |
224 |
$249.15 |