| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
2,150 |
2,098 |
$81K |
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
101 |
78 |
$64K |
| S9999 |
Sales tax |
3,335 |
2,968 |
$25K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
25 |
25 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
71 |
69 |
$3K |
| K0001 |
Standard wheelchair |
52 |
52 |
$325.38 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
15 |
14 |
$48.45 |