| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
14,313 |
13,248 |
$1.96M |
| T4541 |
Large disposable underpad |
37,987 |
34,725 |
$1.64M |
| T4526 |
Adult size pull-on med |
12,235 |
11,090 |
$1.60M |
| T4528 |
Adult size pull-on xl |
11,630 |
10,691 |
$1.47M |
| A4927 |
Non-sterile gloves |
35,463 |
32,035 |
$1.04M |
| T4535 |
Disposable liner/shield/pad |
15,351 |
13,821 |
$775K |
| T4523 |
Adult size brief/diaper lg |
3,626 |
3,263 |
$378K |
| T4524 |
Adult size brief/diaper xl |
2,957 |
2,740 |
$367K |
| T4525 |
Adult size pull-on sm |
2,248 |
2,092 |
$289K |
| T4543 |
Adult disp brief/diap abv xl |
1,278 |
1,102 |
$252K |
| T4534 |
Youth size pull-on |
1,521 |
1,411 |
$199K |
| T4522 |
Adult size brief/diaper med |
2,193 |
1,933 |
$162K |
| A4553 |
Nondisp underpads, all sizes |
6,513 |
5,823 |
$97K |
| K0003 |
Lightweight wheelchair |
1,842 |
1,696 |
$69K |
| A6250 |
Skin seal protect moisturizr |
1,208 |
1,078 |
$56K |
| A4670 |
Automatic bp monitor, dial |
1,350 |
1,274 |
$49K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,142 |
2,041 |
$41K |
| A9286 |
Any hygienic item, device |
2,066 |
1,848 |
$35K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,556 |
1,377 |
$30K |
| E0570 |
Nebulizer with compression |
1,087 |
956 |
$18K |
| K0001 |
Standard wheelchair |
1,080 |
988 |
$13K |
| E0240 |
Bath/shower chair |
453 |
335 |
$13K |
| A4253 |
Blood glucose/reagent strips |
751 |
674 |
$9K |
| E0143 |
Walker folding wheeled w/o s |
471 |
417 |
$7K |
| T4537 |
Reusable underpad bed size |
447 |
446 |
$7K |
| E0156 |
Walker seat attachment |
612 |
537 |
$6K |
| T4530 |
Ped size brief/diaper lg |
65 |
63 |
$6K |
| E0630 |
Patient lift hydraulic |
308 |
270 |
$6K |
| B4035 |
Enteral feed supp pump per d |
43 |
38 |
$5K |
| E0265 |
Hosp bed total electr w/ mat |
449 |
317 |
$3K |
| A4259 |
Lancets per box |
737 |
657 |
$2K |
| A4358 |
Urinary leg or abdomen bag |
45 |
37 |
$2K |
| A4351 |
Straight tip urine catheter |
13 |
12 |
$2K |
| E0266 |
Hosp bed total elec w/o matt |
694 |
575 |
$2K |
| A4245 |
Alcohol wipes per box |
243 |
227 |
$1K |
| E0973 |
W/ch access det adj armrest |
26 |
13 |
$1K |
| E1038 |
Transport chair pt wt<=300lb |
307 |
293 |
$606.01 |
| E0971 |
Wheelchair anti-tipping devi |
26 |
13 |
$178.74 |
| E0607 |
Blood glucose monitor home |
16 |
13 |
$171.70 |
| E0951 |
Loop heel |
26 |
13 |
$123.87 |
| A4663 |
Dialysis blood pressure cuff |
102 |
79 |
$93.26 |
| A7003 |
Nebulizer administration set |
65 |
58 |
$72.18 |
| A4258 |
Lancet device each |
21 |
15 |
$27.96 |
| T2029 |
Special med equip, noswaiver |
32 |
32 |
$0.00 |