| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
10,204 |
10,013 |
$28K |
| A4595 |
Tens suppl 2 lead per month |
9,673 |
9,599 |
$21K |
| T4535 |
Disposable liner/shield/pad |
5,920 |
5,811 |
$18K |
| E0570 |
Nebulizer with compression |
406 |
386 |
$14K |
| T4527 |
Adult size pull-on lg |
3,112 |
3,070 |
$11K |
| T4526 |
Adult size pull-on med |
3,170 |
3,125 |
$11K |
| K0001 |
Standard wheelchair |
646 |
634 |
$9K |
| T4523 |
Adult size brief/diaper lg |
529 |
523 |
$3K |
| T4528 |
Adult size pull-on xl |
2,619 |
2,571 |
$3K |
| E0730 |
Tens four lead |
90 |
68 |
$2K |
| A7005 |
Nondisposable nebulizer set |
403 |
383 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
1,199 |
1,193 |
$2K |
| T4537 |
Reusable underpad bed size |
1,617 |
1,605 |
$2K |
| T4525 |
Adult size pull-on sm |
238 |
236 |
$1K |
| T4524 |
Adult size brief/diaper xl |
288 |
287 |
$1K |
| E0245 |
Tub stool or bench |
810 |
802 |
$1K |
| E0156 |
Walker seat attachment |
628 |
623 |
$501.25 |
| A5500 |
Diab shoe for density insert |
91 |
80 |
$464.49 |
| T4522 |
Adult size brief/diaper med |
284 |
281 |
$313.72 |
| E0105 |
Cane adjust/fixed quad/3 pro |
12 |
12 |
$160.30 |
| E0603 |
Electric breast pump |
17 |
17 |
$159.30 |
| A5512 |
Multi den insert direct form |
56 |
51 |
$155.21 |
| E0163 |
Commode chair with fixed arm |
29 |
29 |
$135.36 |
| A4335 |
Incontinence supply |
69 |
69 |
$115.68 |
| A7015 |
Aerosol mask used w nebulize |
343 |
323 |
$110.48 |
| A6250 |
Skin seal protect moisturizr |
100 |
69 |
$107.50 |
| E0149 |
Heavy duty wheeled walker |
13 |
13 |
$81.45 |
| E0247 |
Trans bench w/wo comm open |
43 |
43 |
$0.00 |