| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
24,293 |
22,737 |
$2.36M |
| T2029 |
Special med equip, noswaiver |
25,950 |
17,152 |
$2.30M |
| T4526 |
Adult size pull-on med |
23,098 |
21,674 |
$2.13M |
| T4528 |
Adult size pull-on xl |
17,957 |
16,623 |
$2.03M |
| A4351 |
Straight tip urine catheter |
10,399 |
9,223 |
$1.93M |
| T4541 |
Large disposable underpad |
47,771 |
44,845 |
$1.93M |
| T4535 |
Disposable liner/shield/pad |
28,322 |
25,853 |
$1.82M |
| K0108 |
W/c component-accessory nos |
14,648 |
5,739 |
$1.75M |
| T4522 |
Adult size brief/diaper med |
12,674 |
11,492 |
$1.63M |
| T4523 |
Adult size brief/diaper lg |
10,537 |
9,696 |
$1.56M |
| E1399 |
Durable medical equipment mi |
2,689 |
1,901 |
$1.50M |
| E0240 |
Bath/shower chair |
2,208 |
2,039 |
$1.31M |
| T4534 |
Youth size pull-on |
10,659 |
9,556 |
$1.27M |
| A4385 |
Ost skn barrier sld ext wear |
14,737 |
13,233 |
$1.14M |
| A4353 |
Intermittent urinary cath |
1,308 |
988 |
$1.12M |
| T4524 |
Adult size brief/diaper xl |
5,978 |
5,535 |
$899K |
| T4544 |
Adlt disp und/pull on abv xl |
5,662 |
5,210 |
$895K |
| A4927 |
Non-sterile gloves |
32,028 |
29,933 |
$840K |
| A4352 |
Coude tip urinary catheter |
1,340 |
1,164 |
$734K |
| B4150 |
Ef complet w/intact nutrient |
5,289 |
4,538 |
$729K |
| T4525 |
Adult size pull-on sm |
6,514 |
6,036 |
$718K |
| K0739 |
Repair/svc dme non-oxygen eq |
17,060 |
14,143 |
$504K |
| T4521 |
Adult size brief/diaper sm |
3,636 |
3,248 |
$481K |
| A5057 |
1 pc ost pou w built-in conv |
2,773 |
2,520 |
$460K |
| E0260 |
Hosp bed semi-electr w/ matt |
9,470 |
9,025 |
$456K |
| A4407 |
Ext wear ost skn barr <=4sq" |
3,151 |
2,838 |
$407K |
| A4357 |
Bedside drainage bag |
20,646 |
17,361 |
$401K |
| T4543 |
Adult disp brief/diap abv xl |
1,787 |
1,630 |
$389K |
| A9999 |
Dme supply or accessory, nos |
1,647 |
934 |
$352K |
| E1028 |
W/c manual swingaway |
7,505 |
4,009 |
$351K |
| T4530 |
Ped size brief/diaper lg |
2,537 |
2,377 |
$341K |
| A4670 |
Automatic bp monitor, dial |
5,191 |
5,082 |
$335K |
| E1161 |
Manual adult wc w tiltinspac |
1,587 |
1,535 |
$328K |
| A4409 |
Ost skn barr convex <=4 sq i |
3,442 |
3,112 |
$280K |
| K0001 |
Standard wheelchair |
11,999 |
11,569 |
$273K |
| A6212 |
Foam drg <=16 sq in w/border |
2,008 |
1,662 |
$267K |
| E0630 |
Patient lift hydraulic |
6,178 |
5,914 |
$248K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,412 |
1,174 |
$247K |
| E0277 |
Powered pres-redu air mattrs |
1,343 |
1,206 |
$244K |
| K0003 |
Lightweight wheelchair |
6,183 |
5,912 |
$243K |
| E0973 |
W/ch access det adj armrest |
17,312 |
9,202 |
$234K |
| A4362 |
Solid skin barrier |
5,285 |
4,911 |
$226K |
| B4035 |
Enteral feed supp pump per d |
1,454 |
1,218 |
$201K |
| A4453 |
Rec cath any transanal, each |
547 |
373 |
$178K |
| A4320 |
Irrigation tray |
1,550 |
1,402 |
$178K |
| A6530 |
Compression stocking bk18-30 |
3,016 |
2,742 |
$172K |
| A4452 |
Waterproof tape |
8,359 |
7,534 |
$171K |
| A4358 |
Urinary leg or abdomen bag |
13,732 |
11,624 |
$165K |
| A4394 |
Ostomy pouch liq deodorant |
4,641 |
4,305 |
$154K |
| A4217 |
Sterile water/saline, 500 ml |
5,075 |
4,528 |
$138K |
| A4338 |
Indwelling catheter latex |
10,643 |
8,659 |
$134K |
| E0261 |
Hosp bed semi-electr w/o mat |
2,548 |
2,483 |
$123K |
| A5056 |
1 pc ost pouch w filter |
1,489 |
1,360 |
$121K |
| A4322 |
Irrigation syringe |
1,907 |
1,555 |
$120K |
| A4419 |
Ost pch for bar w flange/flt |
1,160 |
1,079 |
$114K |
| A6197 |
Alginate drsg >16 <=48 sq in |
319 |
252 |
$113K |
| A4310 |
Insert tray w/o bag/cath |
12,153 |
9,845 |
$102K |
| E0971 |
Wheelchair anti-tipping devi |
17,374 |
9,118 |
$102K |
| E0265 |
Hosp bed total electr w/ mat |
784 |
687 |
$101K |
| A4349 |
Disposable male external cat |
2,375 |
1,838 |
$97K |
| A6216 |
Non-sterile gauze<=16 sq in |
12,241 |
11,484 |
$95K |
| A5120 |
Skin barrier, wipe or swab |
9,342 |
8,766 |
$92K |
| T4533 |
Youth size brief/diaper |
596 |
515 |
$86K |
| A4425 |
Ost pch drain for barrier fl |
1,146 |
1,034 |
$81K |
| E1390 |
Oxygen concentrator |
1,085 |
1,058 |
$80K |
| A5121 |
Solid skin barrier 6x6 |
720 |
674 |
$77K |
| E2311 |
Electro connect btw 2 sys |
58 |
53 |
$76K |
| A6196 |
Alginate dressing <=16 sq in |
342 |
278 |
$69K |
| E0955 |
Cushioned headrest |
1,671 |
1,521 |
$68K |
| E0143 |
Walker folding wheeled w/o s |
1,306 |
1,275 |
$65K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
825 |
717 |
$64K |
| A5063 |
Drain ostomy pouch w/flange |
1,332 |
1,202 |
$63K |
| T4542 |
Small disposable underpad |
2,226 |
2,094 |
$60K |
| E0118 |
Crutch substitute |
1,273 |
1,249 |
$58K |
| E0266 |
Hosp bed total elec w/o matt |
493 |
430 |
$57K |
| A4390 |
Drainable pch ex wear convex |
410 |
337 |
$56K |
| A4456 |
Adhesive remover, wipes |
4,773 |
4,539 |
$54K |
| A6446 |
Conform band s w>=3" <5"/yd |
2,284 |
1,874 |
$53K |
| E0570 |
Nebulizer with compression |
5,197 |
5,105 |
$53K |
| A4430 |
Ost urine pch w b/bltin conv |
456 |
405 |
$53K |
| E1007 |
Pwr seat combo w/shear |
13 |
12 |
$52K |
| A4402 |
Lubricant per ounce |
6,988 |
6,521 |
$50K |
| E0303 |
Hosp bed hvy dty xtra wide |
408 |
389 |
$49K |
| E0978 |
W/c acc,saf belt pelv strap |
8,155 |
7,647 |
$48K |
| E0184 |
Dry pressure mattress |
3,134 |
3,069 |
$47K |
| E1012 |
Ctr mount pwr elev leg rest |
72 |
66 |
$46K |
| E0250 |
Hosp bed fixed ht w/ mattres |
780 |
758 |
$39K |
| K0195 |
Elevating whlchair leg rests |
3,254 |
3,025 |
$39K |
| A4411 |
Ost skn barr extnd =4sq |
388 |
342 |
$39K |
| A6402 |
Sterile gauze <= 16 sq in |
5,313 |
4,896 |
$39K |
| A7030 |
Cpap full face mask |
427 |
419 |
$39K |
| A4432 |
Os pch urine w bar/fange/tap |
701 |
658 |
$38K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
823 |
652 |
$37K |
| K0040 |
Adjustable angle footplate |
1,388 |
805 |
$36K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
916 |
893 |
$33K |
| E0255 |
Hospital bed var ht w/ mattr |
637 |
623 |
$32K |
| K0007 |
Extra heavy duty wheelchair |
412 |
395 |
$31K |
| A6549 |
Grad com garm noc day use |
186 |
140 |
$31K |
| E2611 |
Gen use back cush wdth <22in |
234 |
232 |
$31K |
| E0601 |
Cont airway pressure device |
710 |
704 |
$31K |
| A6451 |
Mod compres band w>=3"<5"/yd |
506 |
468 |
$30K |
| B4154 |
Ef spec metabolic noninherit |
218 |
187 |
$30K |
| A4604 |
Tubing with heating element |
758 |
748 |
$30K |
| A4406 |
Pectin based ostomy paste |
1,661 |
1,590 |
$30K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
488 |
425 |
$29K |
| A4388 |
Drainable pch w ex wear barr |
330 |
305 |
$27K |
| A4416 |
Ost pch clsd w barrier/filtr |
194 |
179 |
$26K |
| A4216 |
Sterile water/saline, 10 ml |
442 |
411 |
$25K |
| A5131 |
Appliance cleaner |
1,001 |
876 |
$24K |
| K0005 |
Ultralightweight wheelchair |
13 |
13 |
$23K |
| A4245 |
Alcohol wipes per box |
4,625 |
4,365 |
$23K |
| A4389 |
Drainable pch w st wear barr |
193 |
165 |
$22K |
| E2601 |
Gen w/c cushion wdth < 22 in |
601 |
578 |
$21K |
| E0600 |
Suction pump portab hom modl |
508 |
491 |
$21K |
| A4333 |
Urinary cath anchor device |
1,867 |
1,721 |
$20K |
| E2203 |
Frame depth less than 22 in |
277 |
255 |
$19K |
| A4624 |
Tracheal suction tube |
179 |
123 |
$19K |
| K0462 |
Temporary replacement eqpmnt |
113 |
99 |
$19K |
| A7031 |
Replacement facemask interfa |
522 |
512 |
$19K |
| B9002 |
Enter nutr inf pump any type |
268 |
210 |
$18K |
| E2219 |
Foam caster tire any size ea |
593 |
437 |
$17K |
| K0823 |
Pwc gp 2 std cap chair |
62 |
62 |
$17K |
| A6260 |
Wound cleanser any type/size |
2,173 |
2,004 |
$17K |
| E0562 |
Humidifier heated used w pap |
1,107 |
1,080 |
$17K |
| E2363 |
Gr24 sealed leadacid battery |
63 |
60 |
$16K |
| E2231 |
Solid seat support base |
502 |
476 |
$15K |
| E2377 |
Expandable controller, initl |
53 |
50 |
$15K |
| A4344 |
Cath indw foley 2 way silicn |
689 |
507 |
$14K |
| E1392 |
Portable oxygen concentrator |
478 |
475 |
$14K |
| E2361 |
22nf sealed leadacid battery |
87 |
84 |
$13K |
| A4427 |
Ost pch drain/barr lk flng/f |
348 |
302 |
$13K |
| E0156 |
Walker seat attachment |
1,103 |
1,074 |
$13K |
| A6443 |
Conform band n/s w>=3"<5"/yd |
575 |
500 |
$12K |
| A6533 |
Gc stocking thighlngth 18-30 |
105 |
101 |
$12K |
| E0159 |
Brake for wheeled walker |
764 |
729 |
$12K |
| A7034 |
Nasal application device |
177 |
174 |
$11K |
| A6457 |
Tubular dressing |
610 |
425 |
$11K |
| A7032 |
Replacement nasal cushion |
337 |
325 |
$10K |
| E0165 |
Commode chair with detacharm |
321 |
315 |
$10K |
| E0956 |
W/c lateral trunk/hip suppor |
187 |
107 |
$10K |
| E1226 |
Manual fully reclining back |
281 |
232 |
$10K |
| A7035 |
Pos airway press headgear |
502 |
496 |
$10K |
| A4367 |
Ostomy belt |
1,284 |
1,199 |
$9K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
258 |
215 |
$9K |
| A4332 |
Lube sterile packet |
670 |
601 |
$9K |
| A7526 |
Tracheostomy tube collar |
203 |
185 |
$9K |
| A4371 |
Skin barrier powder per oz |
1,579 |
1,527 |
$8K |
| E0149 |
Heavy duty wheeled walker |
442 |
427 |
$8K |
| E0247 |
Trans bench w/wo comm open |
59 |
52 |
$8K |
| A4334 |
Urinary cath leg strap |
1,519 |
1,312 |
$8K |
| E0603 |
Electric breast pump |
30 |
29 |
$7K |
| E2213 |
Pneumatic prop tire insert |
795 |
429 |
$7K |
| A4450 |
Non-waterproof tape |
2,601 |
2,416 |
$7K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
53 |
37 |
$7K |
| B9998 |
Enteral supp not otherwise c |
102 |
93 |
$7K |
| E0627 |
Seat lift mech, electric any |
25 |
25 |
$7K |
| E2211 |
Pneumatic propulsion tire |
521 |
294 |
$7K |
| B4088 |
Gastro/jejuno tube, low-pro |
106 |
93 |
$7K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
34 |
25 |
$6K |
| A7038 |
Pos airway pressure filter |
1,443 |
1,420 |
$6K |
| E0244 |
Toilet seat raised |
117 |
116 |
$6K |
| A4649 |
Surgical supplies |
385 |
326 |
$6K |
| A4467 |
Belt strap sleev grmnt cover |
410 |
387 |
$5K |
| E1236 |
Folding ped wc adjustable |
13 |
12 |
$5K |
| A7005 |
Nondisposable nebulizer set |
283 |
279 |
$4K |
| E0951 |
Loop heel |
1,005 |
529 |
$4K |
| E0961 |
Wheelchair brake extension |
567 |
326 |
$4K |
| A4393 |
Urine pch w ex wear bar conv |
28 |
27 |
$4K |
| A4628 |
Oropharyngeal suction cath |
292 |
251 |
$4K |
| A4340 |
Indwelling catheter special |
103 |
79 |
$4K |
| A4629 |
Tracheostomy care kit |
38 |
38 |
$3K |
| E2313 |
Pwc harness, expand control |
15 |
12 |
$3K |
| A7000 |
Disposable canister for pump |
399 |
370 |
$3K |
| A7003 |
Nebulizer administration set |
706 |
653 |
$3K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
13 |
12 |
$3K |
| K0019 |
Arm pad repl, each |
206 |
148 |
$3K |
| A6266 |
Impreg gauze no h20/sal/yard |
42 |
37 |
$3K |
| A6217 |
Non-sterile gauze>16<=48 sq |
279 |
231 |
$3K |
| E1038 |
Transport chair pt wt<=300lb |
171 |
171 |
$2K |
| A6220 |
Gauze >16 <=48 sq in w/bordr |
33 |
25 |
$2K |
| E2392 |
Solid caster tire, integrate |
27 |
24 |
$2K |
| A7002 |
Tubing used w suction pump |
464 |
431 |
$2K |
| E2366 |
Battery charger, single mode |
15 |
14 |
$2K |
| A4396 |
Peristomal hernia supprt blt |
50 |
49 |
$2K |
| E2607 |
Skin pro/pos wc cus wd <22in |
12 |
12 |
$2K |
| A4424 |
Ost pch drain w bar & filter |
31 |
26 |
$2K |
| A7046 |
Repl water chamber, pap dev |
146 |
141 |
$2K |
| A6445 |
Conform band s w <3"/yd |
68 |
54 |
$2K |
| A4410 |
Ost skn barr extnd >4 sq |
12 |
12 |
$2K |
| B4034 |
Enter feed supkit syr by day |
15 |
12 |
$1K |
| E0163 |
Commode chair with fixed arm |
26 |
26 |
$1K |
| E0100 |
Cane adjust/fixed with tip |
44 |
44 |
$926.07 |
| K0002 |
Stnd hemi (low seat) whlchr |
27 |
27 |
$898.74 |
| A7015 |
Aerosol mask used w nebulize |
393 |
381 |
$753.32 |
| E0910 |
Trapeze bar attached to bed |
63 |
61 |
$623.08 |
| E0197 |
Air pressure pad for mattres |
38 |
38 |
$512.28 |
| A4331 |
Extension drainage tubing |
30 |
27 |
$509.36 |
| E2210 |
Wheelchair bearings |
27 |
24 |
$422.85 |
| A4412 |
Ost pouch drain high output |
16 |
13 |
$408.67 |
| A4554 |
Disposable underpads |
15 |
12 |
$326.80 |
| A6219 |
Gauze <= 16 sq in w/border |
16 |
14 |
$309.54 |
| A4213 |
20+ cc syringe only |
15 |
13 |
$304.83 |
| E0621 |
Patient lift sling or seat |
12 |
12 |
$281.52 |
| A6218 |
Non-sterile gauze > 48 sq in |
32 |
24 |
$76.69 |
| A7013 |
Disposable compressor filter |
69 |
68 |
$47.21 |
| A6250 |
Skin seal protect moisturizr |
22 |
14 |
$0.00 |
| A9270 |
Non-covered item or service |
12 |
12 |
$0.00 |