| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Straight tip urine catheter |
1,177 |
1,154 |
$917K |
| T4541 |
Large disposable underpad |
5,399 |
5,351 |
$243K |
| T4534 |
Youth size pull-on |
1,238 |
1,232 |
$237K |
| T4535 |
Disposable liner/shield/pad |
1,648 |
1,634 |
$82K |
| E0570 |
Nebulizer with compression |
673 |
663 |
$77K |
| T4526 |
Adult size pull-on med |
1,119 |
1,111 |
$75K |
| T4523 |
Adult size brief/diaper lg |
832 |
828 |
$64K |
| T4527 |
Adult size pull-on lg |
945 |
942 |
$63K |
| T4522 |
Adult size brief/diaper med |
659 |
656 |
$45K |
| A4927 |
Non-sterile gloves |
1,227 |
1,200 |
$27K |
| E1390 |
Oxygen concentrator |
270 |
269 |
$17K |
| T4528 |
Adult size pull-on xl |
165 |
164 |
$13K |
| A7005 |
Nondisposable nebulizer set |
655 |
648 |
$11K |
| E0443 |
Portable 02 contents, gas |
295 |
232 |
$10K |
| E0431 |
Portable gaseous 02 |
256 |
253 |
$10K |
| A4217 |
Sterile water/saline, 500 ml |
49 |
49 |
$8K |
| T4524 |
Adult size brief/diaper xl |
68 |
67 |
$7K |
| A6250 |
Skin seal protect moisturizr |
412 |
407 |
$6K |
| E1392 |
Portable oxygen concentrator |
166 |
165 |
$5K |
| A4402 |
Lubricant per ounce |
806 |
791 |
$5K |
| A4335 |
Incontinence supply |
401 |
395 |
$4K |
| A4357 |
Bedside drainage bag |
140 |
136 |
$4K |
| A4349 |
Disposable male external cat |
53 |
51 |
$4K |
| A4320 |
Irrigation tray |
114 |
113 |
$4K |
| A4670 |
Automatic bp monitor, dial |
28 |
28 |
$3K |
| A6221 |
Gauze > 48 sq in w/border |
24 |
24 |
$2K |
| A4253 |
Blood glucose/reagent strips |
42 |
42 |
$2K |
| A6446 |
Conform band s w>=3" <5"/yd |
13 |
13 |
$2K |
| T4530 |
Ped size brief/diaper lg |
12 |
12 |
$1K |
| A4358 |
Urinary leg or abdomen bag |
38 |
37 |
$1K |
| A4259 |
Lancets per box |
42 |
42 |
$977.25 |
| A7015 |
Aerosol mask used w nebulize |
575 |
566 |
$719.42 |
| A4456 |
Adhesive remover, wipes |
91 |
89 |
$636.40 |
| A5120 |
Skin barrier, wipe or swab |
70 |
70 |
$628.00 |
| A7035 |
Pos airway press headgear |
26 |
25 |
$368.86 |
| A7037 |
Pos airway pressure tubing |
25 |
24 |
$340.07 |
| A6217 |
Non-sterile gauze>16<=48 sq |
12 |
12 |
$36.70 |
| A7038 |
Pos airway pressure filter |
12 |
12 |
$8.20 |