| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
781 |
600 |
$405K |
| B4150 |
Ef complet w/intact nutrient |
845 |
641 |
$47K |
| B4152 |
Ef calorie dense>/=1.5kcal |
370 |
296 |
$28K |
| B4035 |
Enteral feed supp pump per d |
309 |
268 |
$23K |
| K0001 |
Standard wheelchair |
638 |
591 |
$13K |
| K0003 |
Lightweight wheelchair |
509 |
463 |
$10K |
| A4927 |
Non-sterile gloves |
265 |
258 |
$4K |
| E0627 |
Seat lift mech, electric any |
90 |
66 |
$4K |
| T4541 |
Large disposable underpad |
102 |
91 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
79 |
74 |
$2K |
| K0195 |
Elevating whlchair leg rests |
346 |
327 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
28 |
26 |
$607.35 |
| E1028 |
W/c manual swingaway |
24 |
12 |
$225.33 |