| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
1,466 |
1,418 |
$163K |
| T4541 |
Large disposable underpad |
489 |
485 |
$34K |
| T4526 |
Adult size pull-on med |
204 |
204 |
$22K |
| T4527 |
Adult size pull-on lg |
228 |
227 |
$22K |
| E0570 |
Nebulizer with compression |
132 |
122 |
$13K |
| T4535 |
Disposable liner/shield/pad |
280 |
278 |
$12K |
| A4670 |
Automatic bp monitor, dial |
99 |
93 |
$6K |
| A7005 |
Nondisposable nebulizer set |
143 |
135 |
$3K |
| E0605 |
Vaporizer room type |
16 |
15 |
$360.14 |
| E0990 |
Wheelchair elevating leg res |
15 |
13 |
$331.80 |
| A4927 |
Non-sterile gloves |
37 |
37 |
$282.34 |
| A7015 |
Aerosol mask used w nebulize |
172 |
166 |
$251.31 |
| E0100 |
Cane adjust/fixed with tip |
13 |
13 |
$166.18 |