| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
288 |
284 |
$65K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
68 |
68 |
$5K |
| T4541 |
Incontinence product, disposable underpad, large, each |
278 |
277 |
$4K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
31 |
31 |
$2K |
| 0064A |
|
48 |
48 |
$1K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
43 |
28 |
$1K |
| 90715 |
|
13 |
13 |
$456.79 |
| 0012A |
|
21 |
21 |
$393.12 |
| 0011A |
|
19 |
19 |
$393.12 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
28 |
$346.43 |
| 0134A |
|
14 |
14 |
$259.92 |
| A4927 |
Gloves, non-sterile, per 100 |
26 |
26 |
$110.99 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$73.92 |