| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
64 |
57 |
$392K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,151 |
1,139 |
$339K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
690 |
685 |
$103K |
| E0570 |
Nebulizer, with compressor |
973 |
917 |
$61K |
| E0601 |
Continuous positive airway pressure (cpap) device |
396 |
386 |
$29K |
| A4927 |
Gloves, non-sterile, per 100 |
1,495 |
1,463 |
$24K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
133 |
133 |
$24K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
126 |
125 |
$18K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
144 |
137 |
$16K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
175 |
153 |
$10K |
| K0001 |
Standard wheelchair |
241 |
234 |
$6K |
| T4541 |
Incontinence product, disposable underpad, large, each |
136 |
133 |
$3K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
38 |
38 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
13 |
13 |
$339.53 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
29 |
29 |
$265.11 |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
41 |
41 |
$143.51 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
25 |
24 |
$48.16 |