| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
90,533 |
89,395 |
$3.23M |
| T4527 |
Adult size pull-on lg |
27,301 |
27,033 |
$1.63M |
| T4540 |
Reusable underpad chair size |
47,379 |
46,872 |
$1.49M |
| T4523 |
Adult size brief/diaper lg |
12,601 |
12,374 |
$854K |
| T4526 |
Adult size pull-on med |
12,936 |
12,765 |
$821K |
| T4541 |
Large disposable underpad |
50,628 |
50,099 |
$756K |
| T4528 |
Adult size pull-on xl |
8,844 |
8,734 |
$711K |
| T4543 |
Adult disp brief/diap abv xl |
3,166 |
3,083 |
$598K |
| T4536 |
Reusable pull-on any size |
36,775 |
36,385 |
$559K |
| A4553 |
Nondisp underpads, all sizes |
14,397 |
14,330 |
$513K |
| A4554 |
Disposable underpads |
16,778 |
16,686 |
$498K |
| A4927 |
Non-sterile gloves |
46,828 |
44,677 |
$485K |
| E0260 |
Hosp bed semi-electr w/ matt |
6,913 |
6,679 |
$256K |
| T4524 |
Adult size brief/diaper xl |
3,621 |
3,529 |
$254K |
| T4522 |
Adult size brief/diaper med |
3,581 |
3,539 |
$242K |
| A6533 |
Gc stocking thighlngth 18-30 |
3,813 |
2,224 |
$216K |
| K0004 |
High strength ltwt whlchr |
4,067 |
3,918 |
$195K |
| A6530 |
Compression stocking bk18-30 |
3,240 |
2,048 |
$138K |
| E0143 |
Walker folding wheeled w/o s |
3,162 |
2,985 |
$101K |
| E1390 |
Oxygen concentrator |
3,167 |
3,079 |
$98K |
| A4335 |
Incontinence supply |
749 |
683 |
$96K |
| T4525 |
Adult size pull-on sm |
1,368 |
1,343 |
$86K |
| E2611 |
Gen use back cush wdth <22in |
712 |
699 |
$71K |
| K0001 |
Standard wheelchair |
3,930 |
3,801 |
$54K |
| A4670 |
Automatic bp monitor, dial |
880 |
865 |
$46K |
| A5500 |
Diab shoe for density insert |
2,580 |
1,608 |
$44K |
| E0163 |
Commode chair with fixed arm |
1,245 |
1,200 |
$40K |
| K0003 |
Lightweight wheelchair |
2,526 |
2,476 |
$37K |
| E0240 |
Bath/shower chair |
1,378 |
1,329 |
$36K |
| T4544 |
Adlt disp und/pull on abv xl |
159 |
156 |
$35K |
| E0570 |
Nebulizer with compression |
2,967 |
2,896 |
$32K |
| K0195 |
Elevating whlchair leg rests |
8,029 |
7,703 |
$30K |
| E0247 |
Trans bench w/wo comm open |
422 |
406 |
$26K |
| E0971 |
Wheelchair anti-tipping devi |
1,036 |
823 |
$24K |
| E0261 |
Hosp bed semi-electr w/o mat |
474 |
468 |
$22K |
| A5512 |
Multi den insert direct form |
2,554 |
1,597 |
$19K |
| T4521 |
Adult size brief/diaper sm |
259 |
254 |
$18K |
| E0630 |
Patient lift hydraulic |
890 |
874 |
$16K |
| K0006 |
Heavy duty wheelchair |
425 |
395 |
$16K |
| E2601 |
Gen w/c cushion wdth < 22 in |
724 |
709 |
$16K |
| E0431 |
Portable gaseous 02 |
2,568 |
2,505 |
$14K |
| T4531 |
Ped size pull-on sm/med |
117 |
113 |
$14K |
| E0973 |
W/ch access det adj armrest |
299 |
260 |
$13K |
| E0978 |
W/c acc,saf belt pelv strap |
760 |
739 |
$11K |
| T4530 |
Ped size brief/diaper lg |
93 |
81 |
$10K |
| W0137 |
|
15 |
14 |
$9K |
| L4360 |
Pneumat walking boot pre cst |
57 |
57 |
$9K |
| A4253 |
Blood glucose/reagent strips |
1,004 |
814 |
$8K |
| E0277 |
Powered pres-redu air mattrs |
24 |
24 |
$7K |
| B4150 |
Ef complet w/intact nutrient |
105 |
96 |
$6K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
38 |
38 |
$6K |
| E0156 |
Walker seat attachment |
1,090 |
1,051 |
$5K |
| A4660 |
Sphyg/bp app w cuff and stet |
210 |
206 |
$5K |
| E0951 |
Loop heel |
574 |
458 |
$5K |
| A4928 |
Surgical mask |
325 |
308 |
$5K |
| E0961 |
Wheelchair brake extension |
262 |
245 |
$5K |
| E0144 |
Enclosed walker w rear seat |
53 |
52 |
$5K |
| E0165 |
Commode chair with detacharm |
319 |
315 |
$4K |
| E0100 |
Cane adjust/fixed with tip |
514 |
498 |
$3K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
13 |
12 |
$2K |
| L1833 |
Ko adj jnt pos r sup pre ots |
12 |
12 |
$2K |
| E0627 |
Seat lift mech, electric any |
36 |
36 |
$1K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
15 |
13 |
$1K |
| A4259 |
Lancets per box |
982 |
795 |
$832.38 |
| E0149 |
Heavy duty wheeled walker |
16 |
15 |
$787.61 |
| K0007 |
Extra heavy duty wheelchair |
12 |
12 |
$744.42 |
| E0992 |
Wheelchair solid seat insert |
12 |
12 |
$391.10 |
| E0443 |
Portable 02 contents, gas |
251 |
251 |
$300.66 |