| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
30,806 |
30,377 |
$2.97M |
| L0621 |
Sio flex pelvic/sacr pre ots |
17,144 |
16,686 |
$1.08M |
| E0570 |
Nebulizer with compression |
3,344 |
3,252 |
$330K |
| A4670 |
Automatic bp monitor, dial |
5,744 |
5,604 |
$322K |
| T4541 |
Large disposable underpad |
4,926 |
4,681 |
$271K |
| A4253 |
Blood glucose/reagent strips |
3,560 |
3,351 |
$249K |
| T4528 |
Adult size pull-on xl |
2,063 |
1,975 |
$224K |
| L0628 |
Lso flex no ri stays pre ots |
4,381 |
4,273 |
$217K |
| T4526 |
Adult size pull-on med |
1,808 |
1,722 |
$144K |
| T4527 |
Adult size pull-on lg |
1,405 |
1,365 |
$122K |
| L0625 |
Lo flex l1-below l5 pre ots |
2,974 |
2,968 |
$110K |
| T4535 |
Disposable liner/shield/pad |
1,674 |
1,593 |
$97K |
| A7005 |
Nondisposable nebulizer set |
4,998 |
4,900 |
$88K |
| A6530 |
Compression stocking bk18-30 |
1,227 |
1,118 |
$78K |
| A4259 |
Lancets per box |
3,331 |
3,145 |
$51K |
| E0144 |
Enclosed walker w rear seat |
347 |
335 |
$45K |
| T4525 |
Adult size pull-on sm |
491 |
455 |
$33K |
| E0607 |
Blood glucose monitor home |
436 |
431 |
$28K |
| A6539 |
Gc stocking waistlngth 18-30 |
143 |
134 |
$15K |
| L0626 |
Lo sag rig pnl stays pre cst |
704 |
687 |
$13K |
| L3908 |
Who cock-up nonmolde pre ots |
220 |
215 |
$12K |
| A4927 |
Non-sterile gloves |
618 |
570 |
$7K |
| A7015 |
Aerosol mask used w nebulize |
3,263 |
3,191 |
$4K |
| L1600 |
Ho flex frejka w/cov pre cst |
38 |
38 |
$4K |
| T4522 |
Adult size brief/diaper med |
28 |
24 |
$2K |
| A6533 |
Gc stocking thighlngth 18-30 |
12 |
12 |
$1K |
| T4523 |
Adult size brief/diaper lg |
12 |
12 |
$681.57 |
| E0156 |
Walker seat attachment |
53 |
52 |
$631.77 |
| A4258 |
Lancet device each |
37 |
37 |
$512.89 |
| A4256 |
Calibrator solution/chips |
39 |
39 |
$353.02 |
| E0602 |
Manual breast pump |
18 |
12 |
$344.25 |
| K0001 |
Standard wheelchair |
12 |
12 |
$254.18 |
| A6250 |
Skin seal protect moisturizr |
16 |
15 |
$176.82 |
| A4335 |
Incontinence supply |
14 |
13 |
$88.08 |