| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult size brief/diaper xl |
3,628 |
3,608 |
$368K |
| T4526 |
Adult size pull-on med |
3,908 |
3,895 |
$250K |
| T4541 |
Large disposable underpad |
3,806 |
3,789 |
$214K |
| T4535 |
Disposable liner/shield/pad |
2,107 |
2,093 |
$97K |
| K0001 |
Standard wheelchair |
2,945 |
2,941 |
$83K |
| E0143 |
Walker folding wheeled w/o s |
977 |
958 |
$52K |
| E0570 |
Nebulizer with compression |
2,030 |
2,027 |
$50K |
| E0295 |
Hosp bed semi-elect w/o matt |
541 |
536 |
$38K |
| K0003 |
Lightweight wheelchair |
356 |
355 |
$29K |
| E0163 |
Commode chair with fixed arm |
97 |
92 |
$5K |
| A7005 |
Nondisposable nebulizer set |
162 |
161 |
$3K |
| E0260 |
Hosp bed semi-electr w/ matt |
69 |
69 |
$3K |
| 90694 |
|
27 |
27 |
$2K |
| E0245 |
Tub stool or bench |
27 |
26 |
$1K |
| E0271 |
Mattress innerspring |
43 |
43 |
$1K |
| L3908 |
Who cock-up nonmolde pre ots |
16 |
12 |
$635.55 |
| E0156 |
Walker seat attachment |
41 |
40 |
$611.68 |