| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
32,730 |
31,568 |
$1.53M |
| T4527 |
Adult size pull-on lg |
10,673 |
10,302 |
$1.52M |
| T4523 |
Adult size brief/diaper lg |
8,658 |
8,375 |
$1.12M |
| T4524 |
Adult size brief/diaper xl |
6,268 |
6,047 |
$906K |
| T4528 |
Adult size pull-on xl |
6,927 |
6,702 |
$899K |
| T4526 |
Adult size pull-on med |
6,186 |
5,958 |
$829K |
| T4535 |
Disposable liner/shield/pad |
11,672 |
11,220 |
$625K |
| A4927 |
Non-sterile gloves |
41,079 |
39,621 |
$621K |
| L4361 |
Pneuma/vac walk boot pre ots |
2,719 |
2,636 |
$509K |
| T4522 |
Adult size brief/diaper med |
5,499 |
5,290 |
$498K |
| L1833 |
Ko adj jnt pos r sup pre ots |
974 |
950 |
$381K |
| L3908 |
Who cock-up nonmolde pre ots |
4,612 |
4,044 |
$184K |
| L1820 |
Ko elas w/ condyle pads & jo |
1,605 |
1,356 |
$153K |
| A4553 |
Nondisp underpads, all sizes |
10,272 |
9,936 |
$145K |
| E0114 |
Crutch underarm pair no wood |
3,857 |
3,733 |
$140K |
| T4534 |
Youth size pull-on |
791 |
751 |
$91K |
| K0004 |
High strength ltwt whlchr |
2,722 |
2,625 |
$84K |
| L4360 |
Pneumat walking boot pre cst |
486 |
435 |
$79K |
| L1902 |
Afo ankle gauntlet pre ots |
1,267 |
1,199 |
$71K |
| L3660 |
So 8 ab rstr can/web pre ots |
1,232 |
1,197 |
$70K |
| L3809 |
Whfo w/o joints pre ots |
452 |
430 |
$63K |
| E0973 |
W/ch access det adj armrest |
1,011 |
726 |
$60K |
| E0143 |
Walker folding wheeled w/o s |
1,533 |
1,485 |
$58K |
| K0001 |
Standard wheelchair |
3,778 |
3,406 |
$58K |
| K0195 |
Elevating whlchair leg rests |
6,730 |
6,439 |
$57K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,656 |
1,578 |
$53K |
| L1830 |
Ko immob canvas long pre ots |
989 |
921 |
$52K |
| T4525 |
Adult size pull-on sm |
435 |
414 |
$49K |
| T4543 |
Adult disp brief/diap abv xl |
178 |
174 |
$41K |
| B4035 |
Enteral feed supp pump per d |
310 |
295 |
$39K |
| E0971 |
Wheelchair anti-tipping devi |
763 |
724 |
$30K |
| A4595 |
Tens suppl 2 lead per month |
2,243 |
2,082 |
$26K |
| L3260 |
Ambulatory surgical boot eac |
1,884 |
1,796 |
$25K |
| L4350 |
Ankle control ortho pre ots |
370 |
353 |
$24K |
| L3670 |
So acro/clav can web pre ots |
335 |
324 |
$21K |
| A4670 |
Automatic bp monitor, dial |
518 |
481 |
$19K |
| T4537 |
Reusable underpad bed size |
2,047 |
1,800 |
$16K |
| A4351 |
Straight tip urine catheter |
163 |
154 |
$15K |
| K0003 |
Lightweight wheelchair |
647 |
622 |
$15K |
| E0630 |
Patient lift hydraulic |
487 |
462 |
$14K |
| L1832 |
Ko adj jnt pos r sup pre cst |
36 |
31 |
$13K |
| E0978 |
W/c acc,saf belt pelv strap |
659 |
629 |
$13K |
| E1226 |
Manual fully reclining back |
596 |
578 |
$12K |
| L1851 |
Ko single upright prefab ots |
38 |
26 |
$11K |
| E2601 |
Gen w/c cushion wdth < 22 in |
262 |
249 |
$9K |
| L3807 |
Whfo w/o joints pre cst |
60 |
59 |
$8K |
| L1812 |
Ko elastic w/joints pre ots |
116 |
98 |
$6K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
31 |
26 |
$5K |
| A4554 |
Disposable underpads |
121 |
119 |
$5K |
| E0570 |
Nebulizer with compression |
94 |
77 |
$3K |
| E0730 |
Tens four lead |
57 |
54 |
$2K |
| A4358 |
Urinary leg or abdomen bag |
217 |
201 |
$2K |
| T4521 |
Adult size brief/diaper sm |
25 |
25 |
$2K |
| L2795 |
Knee control full kneecap |
15 |
15 |
$1K |
| A4357 |
Bedside drainage bag |
67 |
60 |
$992.87 |
| E0165 |
Commode chair with detacharm |
12 |
12 |
$683.54 |
| A4253 |
Blood glucose/reagent strips |
147 |
143 |
$631.43 |
| E0163 |
Commode chair with fixed arm |
12 |
12 |
$623.88 |
| E0100 |
Cane adjust/fixed with tip |
48 |
40 |
$468.61 |
| A4520 |
Incontinence garment anytype |
22 |
15 |
$217.66 |
| A4259 |
Lancets per box |
13 |
13 |
$0.00 |