| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
1,780 |
1,464 |
$266K |
| T4526 |
Adult size pull-on med |
1,586 |
1,442 |
$146K |
| A4927 |
Non-sterile gloves |
4,808 |
4,668 |
$137K |
| T4527 |
Adult size pull-on lg |
1,281 |
1,208 |
$132K |
| T4535 |
Disposable liner/shield/pad |
1,123 |
1,030 |
$90K |
| T4528 |
Adult size pull-on xl |
742 |
712 |
$89K |
| T4523 |
Adult size brief/diaper lg |
404 |
370 |
$73K |
| T4541 |
Large disposable underpad |
1,629 |
1,589 |
$64K |
| B4150 |
Ef complet w/intact nutrient |
361 |
294 |
$63K |
| T4544 |
Adlt disp und/pull on abv xl |
254 |
230 |
$57K |
| E0601 |
Cont airway pressure device |
509 |
496 |
$22K |
| E0260 |
Hosp bed semi-electr w/ matt |
388 |
380 |
$20K |
| K0001 |
Standard wheelchair |
687 |
678 |
$16K |
| T4522 |
Adult size brief/diaper med |
108 |
96 |
$16K |
| E0562 |
Humidifier heated used w pap |
573 |
556 |
$10K |
| A4604 |
Tubing with heating element |
123 |
123 |
$8K |
| A4520 |
Incontinence garment anytype |
1,328 |
782 |
$5K |
| A7035 |
Pos airway press headgear |
130 |
129 |
$3K |
| A7038 |
Pos airway pressure filter |
482 |
476 |
$2K |
| A7031 |
Replacement facemask interfa |
49 |
48 |
$2K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
54 |
54 |
$2K |
| E1399 |
Durable medical equipment mi |
14 |
12 |
$1K |
| A7030 |
Cpap full face mask |
12 |
12 |
$1K |
| A7033 |
Replacement nasal pillows |
24 |
24 |
$812.91 |
| E0156 |
Walker seat attachment |
12 |
12 |
$169.00 |
| E0114 |
Crutch underarm pair no wood |
53 |
53 |
$49.30 |
| A7003 |
Nebulizer administration set |
14 |
14 |
$36.94 |