| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
2,173 |
2,173 |
$402K |
| E0570 |
Nebulizer with compression |
3,296 |
3,278 |
$312K |
| T4526 |
Adult size pull-on med |
1,376 |
1,374 |
$115K |
| T4535 |
Disposable liner/shield/pad |
2,138 |
2,119 |
$100K |
| T4527 |
Adult size pull-on lg |
1,270 |
1,250 |
$98K |
| T4541 |
Large disposable underpad |
2,355 |
2,341 |
$83K |
| A4670 |
Automatic bp monitor, dial |
1,218 |
1,208 |
$65K |
| A7005 |
Nondisposable nebulizer set |
3,047 |
3,042 |
$62K |
| K0001 |
Standard wheelchair |
979 |
954 |
$48K |
| T4528 |
Adult size pull-on xl |
370 |
368 |
$39K |
| E0601 |
Cont airway pressure device |
850 |
840 |
$37K |
| A4927 |
Non-sterile gloves |
1,347 |
1,335 |
$30K |
| E0260 |
Hosp bed semi-electr w/ matt |
268 |
262 |
$18K |
| A7031 |
Replacement facemask interfa |
459 |
453 |
$16K |
| A4604 |
Tubing with heating element |
300 |
300 |
$12K |
| K0195 |
Elevating whlchair leg rests |
724 |
699 |
$11K |
| E0245 |
Tub stool or bench |
236 |
230 |
$10K |
| A7038 |
Pos airway pressure filter |
1,487 |
1,474 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
74 |
74 |
$4K |
| A9901 |
Delivery/set up/dispensing |
1,054 |
1,044 |
$3K |
| T4537 |
Reusable underpad bed size |
153 |
153 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,376 |
1,373 |
$2K |
| A7035 |
Pos airway press headgear |
89 |
89 |
$2K |
| E1390 |
Oxygen concentrator |
27 |
27 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
115 |
114 |
$1K |
| A7033 |
Replacement nasal pillows |
26 |
26 |
$811.53 |
| A6530 |
Compression stocking bk18-30 |
15 |
14 |
$710.58 |
| E0100 |
Cane adjust/fixed with tip |
26 |
26 |
$299.25 |
| E0156 |
Walker seat attachment |
15 |
15 |
$204.27 |