| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult size pull-on xl |
162,848 |
161,150 |
$12.20M |
| T4537 |
Reusable underpad bed size |
428,584 |
424,214 |
$12.04M |
| T4527 |
Adult size pull-on lg |
187,335 |
185,306 |
$11.94M |
| T4526 |
Adult size pull-on med |
159,326 |
157,605 |
$9.33M |
| A4927 |
Non-sterile gloves |
302,470 |
299,679 |
$7.60M |
| T4535 |
Disposable liner/shield/pad |
245,387 |
242,726 |
$6.02M |
| E1390 |
Oxygen concentrator |
112,117 |
110,086 |
$5.66M |
| T4541 |
Large disposable underpad |
383,295 |
379,172 |
$5.54M |
| T4544 |
Adlt disp und/pull on abv xl |
43,944 |
42,103 |
$3.88M |
| T4534 |
Youth size pull-on |
54,795 |
53,847 |
$3.83M |
| E1399 |
Durable medical equipment mi |
5,739 |
4,249 |
$2.94M |
| T4525 |
Adult size pull-on sm |
44,752 |
44,097 |
$2.70M |
| A4353 |
Intermittent urinary cath |
5,069 |
4,443 |
$2.50M |
| E0601 |
Cont airway pressure device |
71,060 |
70,239 |
$2.31M |
| T4522 |
Adult size brief/diaper med |
45,786 |
45,269 |
$2.20M |
| T4523 |
Adult size brief/diaper lg |
36,429 |
35,981 |
$2.00M |
| T4524 |
Adult size brief/diaper xl |
28,390 |
28,052 |
$1.84M |
| T4530 |
Ped size brief/diaper lg |
25,011 |
24,580 |
$1.61M |
| A4351 |
Straight tip urine catheter |
23,458 |
21,614 |
$1.61M |
| E0570 |
Nebulizer with compression |
57,977 |
57,343 |
$1.58M |
| T4543 |
Adult disp brief/diap abv xl |
11,549 |
11,333 |
$1.34M |
| E0466 |
Home vent non-invasive inter |
3,483 |
3,440 |
$1.10M |
| E0431 |
Portable gaseous 02 |
72,206 |
70,966 |
$931K |
| T4521 |
Adult size brief/diaper sm |
14,995 |
14,808 |
$901K |
| E0470 |
Rad w/o backup non-inv intfc |
12,287 |
12,202 |
$842K |
| A4253 |
Blood glucose/reagent strips |
78,048 |
67,831 |
$816K |
| E0260 |
Hosp bed semi-electr w/ matt |
15,651 |
15,510 |
$811K |
| A4385 |
Ost skn barrier sld ext wear |
16,160 |
14,334 |
$803K |
| E0465 |
Home vent invasive interface |
1,230 |
1,203 |
$677K |
| E0445 |
Oximeter non-invasive |
3,253 |
3,213 |
$651K |
| E0562 |
Humidifier heated used w pap |
33,046 |
32,587 |
$635K |
| T4532 |
Ped size pull-on lg |
8,439 |
8,330 |
$601K |
| A7030 |
Cpap full face mask |
15,482 |
15,078 |
$595K |
| L4361 |
Pneuma/vac walk boot pre ots |
3,601 |
3,592 |
$552K |
| K0001 |
Standard wheelchair |
28,596 |
28,281 |
$545K |
| E0143 |
Walker folding wheeled w/o s |
11,909 |
11,804 |
$542K |
| A4409 |
Ost skn barr convex <=4 sq i |
9,106 |
8,485 |
$506K |
| E0603 |
Electric breast pump |
4,442 |
4,429 |
$456K |
| T4533 |
Youth size brief/diaper |
7,115 |
7,014 |
$427K |
| K0108 |
W/c component-accessory nos |
3,367 |
2,062 |
$424K |
| K0003 |
Lightweight wheelchair |
8,947 |
8,889 |
$368K |
| A4352 |
Coude tip urinary catheter |
1,891 |
1,533 |
$328K |
| L3908 |
Who cock-up nonmolde pre ots |
7,469 |
6,321 |
$313K |
| A4407 |
Ext wear ost skn barr <=4sq" |
4,586 |
4,222 |
$306K |
| A4425 |
Ost pch drain for barrier fl |
6,940 |
6,409 |
$282K |
| A4362 |
Solid skin barrier |
8,869 |
8,081 |
$270K |
| E0471 |
Rad w/backup non inv intrfc |
1,787 |
1,744 |
$261K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
5,206 |
4,468 |
$253K |
| A6530 |
Compression stocking bk18-30 |
6,221 |
4,909 |
$245K |
| A7005 |
Nondisposable nebulizer set |
21,637 |
21,444 |
$243K |
| A7034 |
Nasal application device |
10,062 |
9,792 |
$239K |
| L1820 |
Ko elas w/ condyle pads & jo |
2,725 |
2,637 |
$228K |
| E0630 |
Patient lift hydraulic |
6,685 |
6,624 |
$214K |
| B4035 |
Enteral feed supp pump per d |
1,445 |
1,379 |
$213K |
| E1392 |
Portable oxygen concentrator |
27,684 |
27,498 |
$211K |
| A6197 |
Alginate drsg >16 <=48 sq in |
673 |
585 |
$204K |
| A4388 |
Drainable pch w ex wear barr |
3,183 |
3,051 |
$195K |
| E1028 |
W/c manual swingaway |
2,125 |
1,794 |
$188K |
| A4458 |
Reusable enema bag |
4,440 |
3,786 |
$180K |
| A7035 |
Pos airway press headgear |
18,049 |
17,593 |
$169K |
| K0823 |
Pwc gp 2 std cap chair |
1,392 |
1,378 |
$164K |
| E2402 |
Neg press wound therapy pump |
609 |
594 |
$160K |
| K0007 |
Extra heavy duty wheelchair |
3,619 |
3,568 |
$159K |
| A4432 |
Os pch urine w bar/fange/tap |
4,884 |
4,398 |
$151K |
| A4624 |
Tracheal suction tube |
1,916 |
1,825 |
$151K |
| A7031 |
Replacement facemask interfa |
8,424 |
8,136 |
$148K |
| A7037 |
Pos airway pressure tubing |
16,527 |
16,154 |
$147K |
| K0004 |
High strength ltwt whlchr |
2,350 |
2,329 |
$144K |
| E2617 |
Custom fab w/c back cushion |
184 |
169 |
$144K |
| E1161 |
Manual adult wc w tiltinspac |
307 |
304 |
$141K |
| A5063 |
Drain ostomy pouch w/flange |
4,926 |
4,568 |
$138K |
| E0250 |
Hosp bed fixed ht w/ mattres |
10,266 |
10,128 |
$137K |
| A6533 |
Gc stocking thighlngth 18-30 |
2,517 |
1,893 |
$133K |
| A4424 |
Ost pch drain w bar & filter |
2,579 |
2,238 |
$132K |
| E1236 |
Folding ped wc adjustable |
331 |
321 |
$129K |
| A4394 |
Ostomy pouch liq deodorant |
10,241 |
9,624 |
$129K |
| E0149 |
Heavy duty wheeled walker |
5,213 |
5,131 |
$128K |
| E0955 |
Cushioned headrest |
1,808 |
1,748 |
$120K |
| L3809 |
Whfo w/o joints pre ots |
875 |
852 |
$116K |
| E2609 |
Custom fabricate w/c cushion |
136 |
127 |
$114K |
| E0114 |
Crutch underarm pair no wood |
4,304 |
4,301 |
$111K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
1,853 |
1,718 |
$110K |
| E0303 |
Hosp bed hvy dty xtra wide |
1,528 |
1,502 |
$109K |
| E0600 |
Suction pump portab hom modl |
2,844 |
2,810 |
$108K |
| A5120 |
Skin barrier, wipe or swab |
18,978 |
16,671 |
$106K |
| E0277 |
Powered pres-redu air mattrs |
1,495 |
1,474 |
$106K |
| A4629 |
Tracheostomy care kit |
2,597 |
2,521 |
$105K |
| A4456 |
Adhesive remover, wipes |
14,238 |
12,685 |
$104K |
| E0971 |
Wheelchair anti-tipping devi |
3,094 |
2,644 |
$104K |
| A5057 |
1 pc ost pou w built-in conv |
1,100 |
1,020 |
$104K |
| K0739 |
Repair/svc dme non-oxygen eq |
2,865 |
2,764 |
$100K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
530 |
489 |
$99K |
| E0607 |
Blood glucose monitor home |
7,108 |
6,399 |
$99K |
| E0730 |
Tens four lead |
2,917 |
2,888 |
$98K |
| L4387 |
Non-pneum walk boot pre ots |
1,091 |
1,087 |
$98K |
| A7038 |
Pos airway pressure filter |
28,193 |
27,809 |
$96K |
| B4150 |
Ef complet w/intact nutrient |
918 |
864 |
$93K |
| A4310 |
Insert tray w/o bag/cath |
7,497 |
6,319 |
$87K |
| K0195 |
Elevating whlchair leg rests |
12,452 |
12,281 |
$82K |
| A4357 |
Bedside drainage bag |
20,238 |
18,854 |
$81K |
| A7526 |
Tracheostomy tube collar |
2,314 |
2,267 |
$81K |
| E0973 |
W/ch access det adj armrest |
1,211 |
1,089 |
$79K |
| A4452 |
Waterproof tape |
4,908 |
4,640 |
$78K |
| E0163 |
Commode chair with fixed arm |
2,090 |
2,051 |
$75K |
| A4419 |
Ost pch for bar w flange/flt |
1,752 |
1,560 |
$74K |
| A6446 |
Conform band s w>=3" <5"/yd |
3,312 |
3,036 |
$72K |
| A4430 |
Ost urine pch w b/bltin conv |
1,138 |
974 |
$72K |
| A4373 |
Skin barrier with flange |
1,205 |
1,044 |
$71K |
| T4540 |
Reusable underpad chair size |
9,573 |
9,425 |
$71K |
| T4531 |
Ped size pull-on sm/med |
1,158 |
1,135 |
$71K |
| K0553 |
Ther cgm supply allowance |
1,171 |
1,100 |
$69K |
| E0240 |
Bath/shower chair |
341 |
333 |
$68K |
| A4259 |
Lancets per box |
61,950 |
54,348 |
$68K |
| E0482 |
Cough stimulating device |
360 |
343 |
$67K |
| A4389 |
Drainable pch w st wear barr |
830 |
769 |
$67K |
| A4604 |
Tubing with heating element |
8,232 |
7,906 |
$66K |
| A4670 |
Automatic bp monitor, dial |
1,256 |
1,252 |
$66K |
| A4332 |
Lube sterile packet |
13,415 |
11,223 |
$66K |
| A4344 |
Cath indw foley 2 way silicn |
3,017 |
2,507 |
$63K |
| A4349 |
Disposable male external cat |
4,427 |
4,149 |
$63K |
| E0565 |
Compressor air power source |
1,460 |
1,449 |
$59K |
| A5056 |
1 pc ost pouch w filter |
964 |
928 |
$56K |
| A5500 |
Diab shoe for density insert |
905 |
716 |
$56K |
| E0156 |
Walker seat attachment |
6,350 |
6,302 |
$55K |
| E2601 |
Gen w/c cushion wdth < 22 in |
2,507 |
2,410 |
$54K |
| B4152 |
Ef calorie dense>/=1.5kcal |
584 |
559 |
$54K |
| A4406 |
Pectin based ostomy paste |
6,660 |
6,362 |
$53K |
| L3670 |
So acro/clav can web pre ots |
867 |
867 |
$52K |
| A7520 |
Trach/laryn tube non-cuffed |
1,894 |
1,847 |
$52K |
| A7032 |
Replacement nasal cushion |
2,909 |
2,815 |
$49K |
| E0960 |
W/c shoulder harness/straps |
853 |
831 |
$49K |
| K0040 |
Adjustable angle footplate |
765 |
705 |
$44K |
| E0978 |
W/c acc,saf belt pelv strap |
2,172 |
2,130 |
$44K |
| T4542 |
Small disposable underpad |
2,406 |
2,362 |
$44K |
| L1902 |
Afo ankle gauntlet pre ots |
987 |
964 |
$43K |
| A4428 |
Urine ost pouch w faucet/tap |
504 |
463 |
$42K |
| A4239 |
Non-adju cgm supply allow |
727 |
717 |
$41K |
| A4358 |
Urinary leg or abdomen bag |
8,684 |
8,027 |
$40K |
| A4623 |
Tracheostomy inner cannula |
550 |
523 |
$38K |
| A7046 |
Repl water chamber, pap dev |
11,990 |
11,845 |
$38K |
| L3020 |
Foot longitud/metatarsal sup |
198 |
175 |
$38K |
| A6402 |
Sterile gauze <= 16 sq in |
4,122 |
3,948 |
$36K |
| A4427 |
Ost pch drain/barr lk flng/f |
1,355 |
1,276 |
$34K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
287 |
260 |
$33K |
| L4350 |
Ankle control ortho pre ots |
509 |
506 |
$32K |
| A7000 |
Disposable canister for pump |
2,814 |
2,763 |
$31K |
| A4371 |
Skin barrier powder per oz |
9,820 |
9,247 |
$31K |
| A5512 |
Multi den insert direct form |
332 |
321 |
$30K |
| A4390 |
Drainable pch ex wear convex |
428 |
352 |
$30K |
| A4322 |
Irrigation syringe |
4,969 |
4,063 |
$30K |
| K0006 |
Heavy duty wheelchair |
1,271 |
1,249 |
$30K |
| A4402 |
Lubricant per ounce |
7,520 |
7,089 |
$29K |
| E0165 |
Commode chair with detacharm |
2,277 |
2,262 |
$29K |
| T4536 |
Reusable pull-on any size |
1,412 |
1,389 |
$27K |
| A4335 |
Incontinence supply |
3,444 |
3,379 |
$27K |
| B9002 |
Enter nutr inf pump any type |
559 |
542 |
$26K |
| E2611 |
Gen use back cush wdth <22in |
476 |
451 |
$26K |
| E0261 |
Hosp bed semi-electr w/o mat |
698 |
693 |
$26K |
| A7033 |
Replacement nasal pillows |
1,640 |
1,569 |
$26K |
| K0005 |
Ultralightweight wheelchair |
25 |
25 |
$25K |
| A4256 |
Calibrator solution/chips |
19,452 |
17,194 |
$23K |
| E0181 |
Press pad alternating w/ pum |
2,875 |
2,847 |
$22K |
| A4367 |
Ostomy belt |
5,228 |
4,935 |
$21K |
| E0100 |
Cane adjust/fixed with tip |
1,878 |
1,874 |
$20K |
| E0951 |
Loop heel |
1,540 |
1,280 |
$18K |
| A4320 |
Irrigation tray |
2,849 |
2,653 |
$17K |
| A4520 |
Incontinence garment anytype |
787 |
604 |
$17K |
| A4450 |
Non-waterproof tape |
3,702 |
3,527 |
$17K |
| E0956 |
W/c lateral trunk/hip suppor |
109 |
94 |
$17K |
| E1038 |
Transport chair pt wt<=300lb |
2,534 |
2,526 |
$17K |
| A6212 |
Foam drg <=16 sq in w/border |
113 |
104 |
$15K |
| E0561 |
Humidifier nonheated w pap |
1,521 |
1,510 |
$15K |
| E0961 |
Wheelchair brake extension |
895 |
717 |
$15K |
| A4405 |
Nonpectin based ostomy paste |
1,638 |
1,528 |
$14K |
| A7015 |
Aerosol mask used w nebulize |
16,720 |
16,565 |
$14K |
| A7003 |
Nebulizer administration set |
10,697 |
10,573 |
$13K |
| E0135 |
Walker folding adjust/fixed |
323 |
321 |
$13K |
| E0245 |
Tub stool or bench |
431 |
421 |
$13K |
| E0168 |
Heavyduty/wide commode chair |
1,476 |
1,447 |
$13K |
| E2213 |
Pneumatic prop tire insert |
369 |
345 |
$12K |
| E2211 |
Pneumatic propulsion tire |
331 |
303 |
$12K |
| E0105 |
Cane adjust/fixed quad/3 pro |
443 |
441 |
$12K |
| S8189 |
Trach supply noc |
73 |
68 |
$11K |
| A4627 |
Spacer bag/reservoir |
1,120 |
1,112 |
$10K |
| E1226 |
Manual fully reclining back |
337 |
328 |
$10K |
| A5061 |
Pouch drainable w barrier at |
342 |
303 |
$9K |
| A4338 |
Indwelling catheter latex |
3,883 |
3,578 |
$9K |
| A4628 |
Oropharyngeal suction cath |
2,203 |
2,151 |
$9K |
| A7036 |
Pos airway press chinstrap |
1,909 |
1,873 |
$9K |
| A4333 |
Urinary cath anchor device |
2,273 |
1,952 |
$8K |
| E0185 |
Gel pressure mattress pad |
107 |
106 |
$8K |
| A6266 |
Impreg gauze no h20/sal/yard |
246 |
235 |
$7K |
| A6539 |
Gc stocking waistlngth 18-30 |
97 |
94 |
$7K |
| B4088 |
Gastro/jejuno tube, low-pro |
81 |
78 |
$7K |
| A7002 |
Tubing used w suction pump |
2,815 |
2,652 |
$7K |
| A4411 |
Ost skn barr extnd =4sq |
58 |
48 |
$6K |
| E0251 |
Hosp bed fixd ht w/o mattres |
454 |
441 |
$6K |
| A4258 |
Lancet device each |
12,619 |
10,815 |
$6K |
| B4034 |
Enter feed supkit syr by day |
566 |
545 |
$6K |
| E0950 |
Tray |
82 |
79 |
$6K |
| E0910 |
Trapeze bar attached to bed |
903 |
890 |
$5K |
| A4412 |
Ost pouch drain high output |
164 |
135 |
$5K |
| A4314 |
Cath w/drainage 2-way latex |
1,636 |
1,549 |
$4K |
| A6531 |
Compress stking bk30-40 surg |
104 |
99 |
$4K |
| A6216 |
Non-sterile gauze<=16 sq in |
765 |
739 |
$4K |
| K0002 |
Stnd hemi (low seat) whlchr |
296 |
293 |
$3K |
| A5513 |
Multi den insert custom mold |
31 |
24 |
$3K |
| A6021 |
Collagen dressing <=16 sq in |
16 |
16 |
$3K |
| L8000 |
Mastectomy bra |
88 |
81 |
$3K |
| A7007 |
Lg vol nebulizer disposable |
843 |
831 |
$3K |
| A4315 |
Cath w/drainage 2-way silcne |
420 |
404 |
$2K |
| E1020 |
Residual limb support system |
73 |
65 |
$2K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
12 |
12 |
$2K |
| T1999 |
Noc retail items andsupplies |
21 |
12 |
$2K |
| A6550 |
Neg pres wound ther drsg set |
14 |
12 |
$2K |
| S5199 |
Personal care item nos each |
652 |
649 |
$2K |
| A7012 |
Nebulizer water collec devic |
665 |
653 |
$2K |
| A7010 |
Disposable corrugated tubing |
149 |
148 |
$2K |
| A7525 |
Tracheostomy mask |
1,555 |
1,483 |
$1K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
27 |
25 |
$1K |
| A4334 |
Urinary cath leg strap |
679 |
613 |
$971.88 |
| K0738 |
Portable gas oxygen system |
95 |
94 |
$839.11 |
| E0244 |
Toilet seat raised |
31 |
28 |
$827.70 |
| Q0513 |
Disp fee inhal drugs/30 days |
109 |
109 |
$759.00 |
| E0184 |
Dry pressure mattress |
28 |
26 |
$748.56 |
| L3660 |
So 8 ab rstr can/web pre ots |
12 |
12 |
$653.91 |
| L1830 |
Ko immob canvas long pre ots |
12 |
12 |
$506.76 |
| E0952 |
Toe loop/holder, each |
30 |
27 |
$473.20 |
| E0776 |
Iv pole |
62 |
62 |
$461.27 |
| B9998 |
Enteral supp not otherwise c |
16 |
12 |
$452.18 |
| A7039 |
Filter, non disposable w pap |
311 |
308 |
$440.12 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
12 |
12 |
$426.99 |
| A4426 |
Ost pch drain 2 piece system |
31 |
24 |
$375.40 |
| A4595 |
Tens suppl 2 lead per month |
26 |
26 |
$352.82 |
| A4364 |
Adhesive, liquid or equal |
56 |
52 |
$272.29 |
| A6260 |
Wound cleanser any type/size |
28 |
26 |
$263.88 |
| A6449 |
Lt compres band >=3" <5"/yd |
13 |
12 |
$106.93 |
| A4398 |
Ostomy irrigation bag |
14 |
12 |
$99.40 |
| A4233 |
Alkalin batt for glucose mon |
128 |
83 |
$21.16 |
| A7018 |
Water distilled w/nebulizer |
16 |
16 |
$13.15 |
| A7013 |
Disposable compressor filter |
539 |
532 |
$6.08 |