| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
103 |
96 |
$21K |
| E0570 |
Nebulizer, with compressor |
459 |
437 |
$19K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
65 |
48 |
$4K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
55 |
51 |
$4K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
122 |
121 |
$3K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
90 |
90 |
$3K |
| K0003 |
Lightweight wheelchair |
39 |
38 |
$1K |