| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5165 |
Home modifications per serv |
742 |
589 |
$1.69M |
| E0603 |
Electric breast pump |
2,652 |
2,650 |
$439K |
| E1399 |
Durable medical equipment mi |
442 |
396 |
$99K |
| K0739 |
Repair/svc dme non-oxygen eq |
772 |
748 |
$55K |
| E0261 |
Hosp bed semi-electr w/o mat |
833 |
819 |
$32K |
| K0004 |
High strength ltwt whlchr |
310 |
295 |
$30K |
| L0625 |
Lo flex l1-below l5 pre ots |
732 |
730 |
$28K |
| E0240 |
Bath/shower chair |
268 |
268 |
$10K |
| E0241 |
Bath tub wall rail |
203 |
134 |
$6K |
| E0570 |
Nebulizer with compression |
66 |
65 |
$6K |
| A6530 |
Compression stocking bk18-30 |
146 |
112 |
$5K |
| E0143 |
Walker folding wheeled w/o s |
77 |
77 |
$4K |
| L3908 |
Who cock-up nonmolde pre ots |
84 |
67 |
$4K |
| A4670 |
Automatic bp monitor, dial |
48 |
48 |
$2K |
| E1161 |
Manual adult wc w tiltinspac |
12 |
12 |
$1K |
| E0243 |
Toilet rail |
17 |
15 |
$1K |
| E0247 |
Trans bench w/wo comm open |
13 |
13 |
$882.14 |
| E0630 |
Patient lift hydraulic |
26 |
24 |
$869.46 |
| E0156 |
Walker seat attachment |
25 |
25 |
$389.09 |
| E0244 |
Toilet seat raised |
14 |
14 |
$288.41 |
| A7005 |
Nondisposable nebulizer set |
13 |
13 |
$200.75 |