| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
12,697 |
12,142 |
$1.22M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
15,588 |
14,914 |
$1.01M |
| T4541 |
Incontinence product, disposable underpad, large, each |
15,992 |
15,261 |
$831K |
| A6214 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
660 |
635 |
$317K |
| A4927 |
Gloves, non-sterile, per 100 |
16,175 |
15,528 |
$211K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
380 |
365 |
$185K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,559 |
2,453 |
$127K |
| A4217 |
Sterile water/saline, 500 ml |
1,523 |
1,492 |
$112K |
| A4670 |
Automatic blood pressure monitor |
2,369 |
2,279 |
$101K |
| K0001 |
Standard wheelchair |
3,865 |
3,670 |
$85K |
| A4327 |
Female external urinary collection device; meatal cup, each |
91 |
89 |
$75K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
902 |
859 |
$65K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
1,390 |
1,273 |
$59K |
| A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
1,094 |
1,077 |
$39K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
283 |
279 |
$36K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
616 |
605 |
$30K |
| K0003 |
Lightweight wheelchair |
926 |
894 |
$30K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
142 |
142 |
$29K |
| E0570 |
Nebulizer, with compressor |
2,261 |
2,239 |
$28K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
292 |
263 |
$27K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
794 |
776 |
$23K |
| A6545 |
Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each |
68 |
68 |
$19K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
272 |
229 |
$18K |
| A6220 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
224 |
221 |
$16K |
| E0305 |
Bed side rails, half length |
970 |
863 |
$15K |
| E0245 |
Tub stool or bench |
382 |
335 |
$15K |
| E2622 |
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
178 |
171 |
$11K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
49 |
49 |
$10K |
| E0144 |
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat |
1,415 |
1,411 |
$10K |
| E0271 |
Mattress, innerspring |
825 |
721 |
$9K |
| K0806 |
Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds |
14 |
14 |
$9K |
| K0007 |
Extra heavy duty wheelchair |
206 |
205 |
$8K |
| E0601 |
Continuous positive airway pressure (cpap) device |
146 |
135 |
$8K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
598 |
576 |
$7K |
| E0156 |
Seat attachment, walker |
760 |
743 |
$6K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
933 |
919 |
$5K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
87 |
87 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
431 |
415 |
$5K |
| E0210 |
Electric heat pad, standard |
301 |
301 |
$5K |
| A6259 |
Transparent film, sterile, more than 48 sq. in., each dressing |
28 |
28 |
$4K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
345 |
332 |
$3K |
| A5120 |
Skin barrier, wipes or swabs, each |
144 |
133 |
$3K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
713 |
701 |
$2K |
| E0310 |
Bed side rails, full length |
275 |
272 |
$2K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
87 |
86 |
$2K |
| E0244 |
Raised toilet seat |
46 |
44 |
$2K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
227 |
223 |
$1K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
18 |
18 |
$1K |
| E0241 |
Bath tub wall rail, each |
53 |
52 |
$993.55 |
| A7015 |
Aerosol mask, used with dme nebulizer |
604 |
579 |
$990.35 |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
73 |
72 |
$845.96 |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13 |
12 |
$770.12 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
13 |
12 |
$759.80 |
| E0243 |
Toilet rail, each |
14 |
14 |
$680.97 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
140 |
140 |
$542.34 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
376 |
364 |
$365.99 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
37 |
37 |
$291.77 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
66 |
65 |
$152.78 |