| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
21,061 |
18,166 |
$1.47M |
| T4527 |
Adult size pull-on lg |
8,855 |
8,113 |
$789K |
| T4535 |
Disposable liner/shield/pad |
11,716 |
10,554 |
$611K |
| T4526 |
Adult size pull-on med |
8,170 |
7,496 |
$599K |
| E0601 |
Cont airway pressure device |
7,763 |
6,807 |
$543K |
| T4528 |
Adult size pull-on xl |
5,106 |
4,836 |
$489K |
| A7031 |
Replacement facemask interfa |
4,532 |
3,975 |
$382K |
| A4215 |
Sterile needle |
9,319 |
9,016 |
$307K |
| A7030 |
Cpap full face mask |
2,907 |
2,632 |
$290K |
| A7032 |
Replacement nasal cushion |
2,985 |
2,650 |
$257K |
| E1390 |
Oxygen concentrator |
5,510 |
4,657 |
$255K |
| T4534 |
Youth size pull-on |
3,068 |
2,618 |
$254K |
| A4927 |
Non-sterile gloves |
20,813 |
19,191 |
$248K |
| T4543 |
Adult disp brief/diap abv xl |
1,861 |
1,734 |
$219K |
| T4523 |
Adult size brief/diaper lg |
1,892 |
1,752 |
$190K |
| A4259 |
Lancets per box |
16,222 |
14,378 |
$176K |
| T4522 |
Adult size brief/diaper med |
1,939 |
1,792 |
$167K |
| A4604 |
Tubing with heating element |
4,831 |
4,347 |
$165K |
| E0562 |
Humidifier heated used w pap |
7,851 |
6,930 |
$157K |
| E0260 |
Hosp bed semi-electr w/ matt |
5,368 |
4,196 |
$157K |
| A7034 |
Nasal application device |
2,539 |
2,280 |
$153K |
| T4537 |
Reusable underpad bed size |
3,766 |
3,547 |
$152K |
| E0570 |
Nebulizer with compression |
7,483 |
5,803 |
$150K |
| K0001 |
Standard wheelchair |
7,626 |
6,195 |
$133K |
| A4239 |
Non-adju cgm supply allow |
514 |
493 |
$117K |
| A7035 |
Pos airway press headgear |
4,872 |
4,363 |
$100K |
| T4524 |
Adult size brief/diaper xl |
1,023 |
945 |
$100K |
| A7038 |
Pos airway pressure filter |
7,710 |
6,909 |
$97K |
| S8490 |
100 insulin syringes |
4,212 |
4,024 |
$92K |
| A4670 |
Automatic bp monitor, dial |
1,781 |
1,637 |
$89K |
| A4351 |
Straight tip urine catheter |
916 |
715 |
$89K |
| T4541 |
Large disposable underpad |
4,878 |
4,158 |
$89K |
| T4525 |
Adult size pull-on sm |
1,367 |
1,248 |
$84K |
| E0143 |
Walker folding wheeled w/o s |
1,569 |
1,331 |
$66K |
| A7033 |
Replacement nasal pillows |
1,121 |
968 |
$55K |
| A7037 |
Pos airway pressure tubing |
2,340 |
2,101 |
$50K |
| L3908 |
Who cock-up nonmolde pre ots |
1,074 |
624 |
$47K |
| E0630 |
Patient lift hydraulic |
1,533 |
1,215 |
$41K |
| A4245 |
Alcohol wipes per box |
5,767 |
5,619 |
$33K |
| E0431 |
Portable gaseous 02 |
2,877 |
2,359 |
$24K |
| A7046 |
Repl water chamber, pap dev |
2,226 |
1,980 |
$21K |
| K0553 |
Ther cgm supply allowance |
126 |
123 |
$16K |
| K0007 |
Extra heavy duty wheelchair |
188 |
142 |
$14K |
| A7039 |
Filter, non disposable w pap |
1,730 |
1,553 |
$13K |
| E0607 |
Blood glucose monitor home |
225 |
222 |
$13K |
| K0006 |
Heavy duty wheelchair |
288 |
243 |
$11K |
| E0181 |
Press pad alternating w/ pum |
1,842 |
1,422 |
$10K |
| A7003 |
Nebulizer administration set |
3,421 |
3,076 |
$9K |
| K0195 |
Elevating whlchair leg rests |
1,000 |
856 |
$8K |
| E0156 |
Walker seat attachment |
844 |
702 |
$7K |
| E0470 |
Rad w/o backup non-inv intfc |
66 |
65 |
$7K |
| K0003 |
Lightweight wheelchair |
236 |
213 |
$6K |
| E0114 |
Crutch underarm pair no wood |
157 |
144 |
$5K |
| E0245 |
Tub stool or bench |
33 |
27 |
$2K |
| E0163 |
Commode chair with fixed arm |
75 |
64 |
$2K |
| E0910 |
Trapeze bar attached to bed |
373 |
305 |
$2K |
| A4627 |
Spacer bag/reservoir |
54 |
51 |
$969.24 |
| B4035 |
Enteral feed supp pump per d |
15 |
12 |
$505.47 |
| E1392 |
Portable oxygen concentrator |
12 |
12 |
$365.73 |
| K0739 |
Repair/svc dme non-oxygen eq |
15 |
12 |
$275.71 |
| A7015 |
Aerosol mask used w nebulize |
111 |
105 |
$159.93 |
| A4357 |
Bedside drainage bag |
31 |
25 |
$68.88 |
| A4520 |
Incontinence garment anytype |
79 |
44 |
$0.00 |