| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer with compression |
1,254 |
1,230 |
$94K |
| K0003 |
Lightweight wheelchair |
689 |
622 |
$51K |
| A4353 |
Intermittent urinary cath |
156 |
156 |
$45K |
| L0648 |
Lso sag r an/pos pnl pre ots |
146 |
104 |
$37K |
| L1833 |
Ko adj jnt pos r sup pre ots |
169 |
99 |
$22K |
| L3030 |
Foot arch support remov prem |
254 |
125 |
$19K |
| E0260 |
Hosp bed semi-electr w/ matt |
445 |
423 |
$19K |
| A4554 |
Disposable underpads |
666 |
641 |
$18K |
| K0195 |
Elevating whlchair leg rests |
835 |
756 |
$13K |
| E0973 |
W/ch access det adj armrest |
361 |
151 |
$12K |
| L1971 |
Afo w/ankle joint, prefab |
50 |
23 |
$11K |
| A4927 |
Non-sterile gloves |
593 |
570 |
$10K |
| E2611 |
Gen use back cush wdth <22in |
151 |
118 |
$10K |
| A7005 |
Nondisposable nebulizer set |
1,219 |
1,199 |
$9K |
| T4527 |
Adult size pull-on lg |
113 |
110 |
$7K |
| L3216 |
Orthoped ladies shoes dpth i |
142 |
70 |
$5K |
| L3807 |
Whfo w/o joints pre cst |
33 |
18 |
$4K |
| A6531 |
Compress stking bk30-40 surg |
66 |
32 |
$3K |
| E0163 |
Commode chair with fixed arm |
97 |
85 |
$3K |
| E2601 |
Gen w/c cushion wdth < 22 in |
165 |
127 |
$3K |
| T4526 |
Adult size pull-on med |
36 |
25 |
$3K |
| A4670 |
Automatic bp monitor, dial |
123 |
117 |
$2K |
| L0180 |
Cer post col occ/man sup adj |
19 |
16 |
$2K |
| L2397 |
Suspension sleeve lower ext |
38 |
26 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
30 |
29 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
94 |
44 |
$1K |
| E0245 |
Tub stool or bench |
14 |
14 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
1,214 |
1,196 |
$1K |
| E0240 |
Bath/shower chair |
21 |
15 |
$1K |
| E0630 |
Patient lift hydraulic |
12 |
12 |
$569.93 |
| E0978 |
W/c acc,saf belt pelv strap |
30 |
27 |
$385.77 |
| E0167 |
Commode chair pail or pan |
78 |
65 |
$6.75 |
| A7003 |
Nebulizer administration set |
1,212 |
1,192 |
$1.56 |