| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,171 |
2,046 |
$148K |
| T4527 |
Adult size pull-on lg |
393 |
366 |
$87K |
| E0424 |
Stationary compressed gas 02 |
1,034 |
972 |
$84K |
| L0650 |
Lso sc r ant/pos pnl pre ots |
108 |
105 |
$74K |
| E1392 |
Portable oxygen concentrator |
1,020 |
960 |
$35K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
108 |
102 |
$31K |
| L0635 |
Lso sagit rigid panel prefab |
177 |
176 |
$30K |
| A4253 |
Blood glucose/reagent strips |
1,498 |
1,378 |
$30K |
| A4554 |
Disposable underpads |
459 |
431 |
$27K |
| E0217 |
Water circ heat pad w pump |
64 |
55 |
$25K |
| A4215 |
Sterile needle |
903 |
817 |
$23K |
| E0431 |
Portable gaseous 02 |
1,124 |
1,047 |
$19K |
| E0190 |
Positioning cushion |
53 |
47 |
$12K |
| A6531 |
Compress stking bk30-40 surg |
143 |
131 |
$10K |
| A4927 |
Non-sterile gloves |
426 |
408 |
$8K |
| E0570 |
Nebulizer with compression |
169 |
161 |
$8K |
| L1833 |
Ko adj jnt pos r sup pre ots |
30 |
28 |
$7K |
| A4259 |
Lancets per box |
1,206 |
1,107 |
$6K |
| A5120 |
Skin barrier, wipe or swab |
499 |
469 |
$3K |
| L1836 |
Ko rigid w/o joints pre ots |
28 |
24 |
$3K |
| A6250 |
Skin seal protect moisturizr |
493 |
465 |
$2K |
| A4670 |
Automatic bp monitor, dial |
16 |
12 |
$765.78 |