| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5165 |
Home modifications per serv |
1,358 |
1,256 |
$5.71M |
| T2029 |
Special med equip, noswaiver |
2,771 |
2,281 |
$713K |
| T4541 |
Large disposable underpad |
4,172 |
3,962 |
$156K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,420 |
2,166 |
$148K |
| K0003 |
Lightweight wheelchair |
2,444 |
2,224 |
$145K |
| T4528 |
Adult size pull-on xl |
1,211 |
1,106 |
$115K |
| T4527 |
Adult size pull-on lg |
998 |
923 |
$90K |
| B4150 |
Ef complet w/intact nutrient |
784 |
728 |
$69K |
| E1028 |
W/c manual swingaway |
1,366 |
923 |
$68K |
| T4535 |
Disposable liner/shield/pad |
1,483 |
1,410 |
$66K |
| T4526 |
Adult size pull-on med |
774 |
753 |
$65K |
| E0143 |
Walker folding wheeled w/o s |
1,794 |
1,672 |
$62K |
| A4927 |
Non-sterile gloves |
4,186 |
3,958 |
$59K |
| E0570 |
Nebulizer with compression |
1,315 |
1,204 |
$59K |
| K0001 |
Standard wheelchair |
1,537 |
1,406 |
$46K |
| A4670 |
Automatic bp monitor, dial |
1,069 |
1,031 |
$45K |
| K0823 |
Pwc gp 2 std cap chair |
197 |
181 |
$41K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
476 |
407 |
$21K |
| E0971 |
Wheelchair anti-tipping devi |
3,752 |
1,694 |
$16K |
| E0245 |
Tub stool or bench |
457 |
441 |
$14K |
| E0990 |
Wheelchair elevating leg res |
805 |
375 |
$12K |
| E0730 |
Tens four lead |
162 |
162 |
$11K |
| K0195 |
Elevating whlchair leg rests |
807 |
653 |
$11K |
| E0149 |
Heavy duty wheeled walker |
323 |
304 |
$10K |
| E0156 |
Walker seat attachment |
1,094 |
1,029 |
$10K |
| K0007 |
Extra heavy duty wheelchair |
96 |
76 |
$7K |
| A6530 |
Compression stocking bk18-30 |
121 |
107 |
$6K |
| E0165 |
Commode chair with detacharm |
300 |
242 |
$5K |
| E0247 |
Trans bench w/wo comm open |
76 |
61 |
$4K |
| L3908 |
Who cock-up nonmolde pre ots |
82 |
75 |
$3K |
| E0114 |
Crutch underarm pair no wood |
129 |
126 |
$3K |
| E0973 |
W/ch access det adj armrest |
18 |
12 |
$2K |
| E0630 |
Patient lift hydraulic |
14 |
12 |
$2K |
| E2611 |
Gen use back cush wdth <22in |
19 |
15 |
$1K |
| A4351 |
Straight tip urine catheter |
12 |
12 |
$1K |
| E2601 |
Gen w/c cushion wdth < 22 in |
33 |
26 |
$1K |
| T4522 |
Adult size brief/diaper med |
12 |
12 |
$1K |
| E0951 |
Loop heel |
338 |
143 |
$999.36 |
| E0100 |
Cane adjust/fixed with tip |
15 |
12 |
$133.86 |