| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6530 |
Compression stocking bk18-30 |
2,454 |
1,731 |
$105K |
| E0570 |
Nebulizer with compression |
932 |
931 |
$95K |
| E1399 |
Durable medical equipment mi |
497 |
450 |
$66K |
| L3908 |
Who cock-up nonmolde pre ots |
880 |
781 |
$41K |
| K0001 |
Standard wheelchair |
1,012 |
978 |
$32K |
| E0143 |
Walker folding wheeled w/o s |
602 |
599 |
$28K |
| E0261 |
Hosp bed semi-electr w/o mat |
369 |
364 |
$25K |
| A4554 |
Disposable underpads |
586 |
544 |
$24K |
| A4670 |
Automatic bp monitor, dial |
465 |
457 |
$21K |
| E0240 |
Bath/shower chair |
184 |
182 |
$6K |
| S8101 |
Spacer with mask |
168 |
167 |
$5K |
| T4522 |
Adult size brief/diaper med |
51 |
51 |
$4K |
| E0156 |
Walker seat attachment |
246 |
245 |
$4K |
| T4523 |
Adult size brief/diaper lg |
36 |
36 |
$4K |
| T4524 |
Adult size brief/diaper xl |
26 |
25 |
$2K |
| A4425 |
Ost pch drain for barrier fl |
49 |
48 |
$2K |
| A6531 |
Compress stking bk30-40 surg |
15 |
13 |
$765.96 |
| T4535 |
Disposable liner/shield/pad |
14 |
13 |
$277.88 |
| E0100 |
Cane adjust/fixed with tip |
25 |
25 |
$225.72 |
| A4927 |
Non-sterile gloves |
28 |
26 |
$110.69 |