| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
1,047 |
1,014 |
$474K |
| E0570 |
Nebulizer, with compressor |
1,597 |
1,588 |
$168K |
| A4554 |
Disposable underpads, all sizes |
1,070 |
1,067 |
$81K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
713 |
712 |
$24K |
| L3215 |
Orthopedic footwear, ladies shoe, oxford, each |
124 |
119 |
$15K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
575 |
572 |
$10K |
| L3219 |
Orthopedic footwear, mens shoe, oxford, each |
38 |
37 |
$6K |
| A4927 |
Gloves, non-sterile, per 100 |
1,248 |
1,243 |
$5K |
| L3480 |
Heel, pad and depression for spur |
51 |
50 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,456 |
1,445 |
$1K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12 |
12 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
68 |
68 |
$991.44 |