| Code | Description | Claims | Beneficiaries | Total Paid |
| T4541 |
Large disposable underpad |
95 |
93 |
$5K |
| E0601 |
Cont airway pressure device |
108 |
78 |
$1K |
| E0570 |
Nebulizer with compression |
138 |
125 |
$46.48 |
| T4535 |
Disposable liner/shield/pad |
85 |
85 |
$0.00 |
| A7015 |
Aerosol mask used w nebulize |
13 |
13 |
$0.00 |
| A4253 |
Blood glucose/reagent strips |
17 |
13 |
$0.00 |
| T4526 |
Adult size pull-on med |
40 |
39 |
$0.00 |
| A7038 |
Pos airway pressure filter |
60 |
60 |
$0.00 |
| A7005 |
Nondisposable nebulizer set |
44 |
44 |
$0.00 |
| E0260 |
Hosp bed semi-electr w/ matt |
12 |
12 |
$0.00 |
| T4528 |
Adult size pull-on xl |
13 |
13 |
$0.00 |