| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,815 |
1,519 |
$197K |
| K0001 |
Standard wheelchair |
3,249 |
3,090 |
$79K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,349 |
2,193 |
$67K |
| K0003 |
Lightweight wheelchair |
310 |
296 |
$14K |
| K0004 |
High strength, lightweight wheelchair |
251 |
233 |
$13K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
201 |
173 |
$5K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
55 |
51 |
$1K |
| E0570 |
Nebulizer, with compressor |
27 |
21 |
$1K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
30 |
28 |
$546.65 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
13 |
12 |
$273.93 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
19 |
17 |
$209.57 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
14 |
13 |
$105.00 |