| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4239 |
Non-adju cgm supply allow |
633 |
576 |
$56K |
| K0553 |
Ther cgm supply allowance |
441 |
405 |
$54K |
| L3010 |
Foot longitudinal arch suppo |
272 |
152 |
$28K |
| A4927 |
Non-sterile gloves |
698 |
632 |
$12K |
| L3216 |
Orthoped ladies shoes dpth i |
111 |
76 |
$9K |
| A6530 |
Compression stocking bk18-30 |
88 |
74 |
$6K |
| L3030 |
Foot arch support remov prem |
110 |
63 |
$6K |
| A4670 |
Automatic bp monitor, dial |
204 |
175 |
$4K |
| A4554 |
Disposable underpads |
98 |
91 |
$4K |
| E0570 |
Nebulizer with compression |
110 |
99 |
$3K |
| 87635 |
|
68 |
45 |
$2K |
| T4527 |
Adult size pull-on lg |
15 |
15 |
$2K |
| A5512 |
Multi den insert direct form |
57 |
26 |
$1K |
| A5500 |
Diab shoe for density insert |
56 |
26 |
$1K |
| T4535 |
Disposable liner/shield/pad |
39 |
38 |
$328.68 |
| A4253 |
Blood glucose/reagent strips |
26 |
24 |
$3.33 |