| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
112 |
94 |
$45K |
| A5500 |
Diab shoe for density insert |
438 |
329 |
$40K |
| K0001 |
Standard wheelchair |
1,216 |
1,177 |
$28K |
| A5512 |
Multi den insert direct form |
232 |
169 |
$24K |
| A4352 |
Coude tip urinary catheter |
27 |
25 |
$20K |
| E0570 |
Nebulizer with compression |
312 |
302 |
$16K |
| T4527 |
Adult size pull-on lg |
136 |
135 |
$16K |
| E0118 |
Crutch substitute |
851 |
234 |
$16K |
| A4670 |
Automatic bp monitor, dial |
102 |
100 |
$5K |
| A7005 |
Nondisposable nebulizer set |
178 |
176 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
26 |
26 |
$3K |
| T4541 |
Large disposable underpad |
25 |
25 |
$2K |
| A6530 |
Compression stocking bk18-30 |
38 |
37 |
$2K |
| K0053 |
Elevate footrest articulate |
167 |
134 |
$2K |
| T4535 |
Disposable liner/shield/pad |
12 |
12 |
$1K |
| B4150 |
Ef complet w/intact nutrient |
18 |
14 |
$845.85 |
| E0100 |
Cane adjust/fixed with tip |
148 |
140 |
$636.99 |
| E0141 |
Rigid wheeled walker adj/fix |
12 |
12 |
$0.00 |