| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
4,565 |
4,557 |
$219K |
| T4523 |
Adult size brief/diaper lg |
1,373 |
1,372 |
$161K |
| T4526 |
Adult size pull-on med |
1,538 |
1,536 |
$71K |
| K0001 |
Standard wheelchair |
1,175 |
1,161 |
$54K |
| T4527 |
Adult size pull-on lg |
882 |
882 |
$50K |
| K0003 |
Lightweight wheelchair |
578 |
565 |
$25K |
| E0601 |
Cont airway pressure device |
168 |
168 |
$25K |
| E0562 |
Humidifier heated used w pap |
309 |
309 |
$13K |
| E0143 |
Walker folding wheeled w/o s |
334 |
329 |
$13K |
| T4522 |
Adult size brief/diaper med |
158 |
158 |
$13K |
| E0570 |
Nebulizer with compression |
223 |
222 |
$12K |
| E0431 |
Portable gaseous 02 |
329 |
329 |
$7K |
| T4535 |
Disposable liner/shield/pad |
160 |
158 |
$6K |
| E0470 |
Rad w/o backup non-inv intfc |
13 |
13 |
$6K |
| T4525 |
Adult size pull-on sm |
101 |
101 |
$5K |
| K0195 |
Elevating whlchair leg rests |
111 |
109 |
$3K |
| E1038 |
Transport chair pt wt<=300lb |
363 |
352 |
$2K |
| A7038 |
Pos airway pressure filter |
200 |
198 |
$1K |
| A7035 |
Pos airway press headgear |
42 |
42 |
$1K |
| A7034 |
Nasal application device |
15 |
15 |
$840.79 |
| E0156 |
Walker seat attachment |
150 |
149 |
$754.28 |
| K0823 |
Pwc gp 2 std cap chair |
12 |
12 |
$696.14 |
| E0245 |
Tub stool or bench |
13 |
13 |
$691.65 |
| A7037 |
Pos airway pressure tubing |
28 |
28 |
$664.36 |
| A7039 |
Filter, non disposable w pap |
27 |
27 |
$247.28 |
| A4253 |
Blood glucose/reagent strips |
21 |
14 |
$11.46 |
| A7015 |
Aerosol mask used w nebulize |
14 |
14 |
$3.57 |