| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
982 |
924 |
$95K |
| E0601 |
Cont airway pressure device |
710 |
708 |
$36K |
| B4150 |
Ef complet w/intact nutrient |
376 |
283 |
$28K |
| T4541 |
Large disposable underpad |
899 |
886 |
$21K |
| T4528 |
Adult size pull-on xl |
143 |
135 |
$15K |
| T4535 |
Disposable liner/shield/pad |
339 |
329 |
$11K |
| A4253 |
Blood glucose/reagent strips |
934 |
886 |
$10K |
| E1390 |
Oxygen concentrator |
98 |
98 |
$6K |
| A4604 |
Tubing with heating element |
148 |
148 |
$6K |
| A4927 |
Non-sterile gloves |
404 |
368 |
$6K |
| E0570 |
Nebulizer with compression |
809 |
803 |
$6K |
| A7030 |
Cpap full face mask |
39 |
39 |
$4K |
| A7038 |
Pos airway pressure filter |
526 |
526 |
$3K |
| K0553 |
Ther cgm supply allowance |
12 |
12 |
$2K |
| T4526 |
Adult size pull-on med |
27 |
26 |
$2K |
| E0562 |
Humidifier heated used w pap |
164 |
163 |
$1K |
| A7035 |
Pos airway press headgear |
14 |
14 |
$378.85 |
| A4259 |
Lancets per box |
114 |
106 |
$89.36 |