| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5199 |
Personal care item nos each |
2,410 |
2,234 |
$1.25M |
| A4624 |
Tracheal suction tube |
633 |
543 |
$161K |
| A4554 |
Disposable underpads |
2,203 |
2,108 |
$105K |
| A4927 |
Non-sterile gloves |
2,926 |
2,306 |
$40K |
| A4629 |
Tracheostomy care kit |
770 |
653 |
$38K |
| E0431 |
Portable gaseous 02 |
768 |
717 |
$26K |
| A5131 |
Appliance cleaner |
2,915 |
1,504 |
$20K |
| A7003 |
Nebulizer administration set |
3,962 |
1,497 |
$11K |
| A4216 |
Sterile water/saline, 10 ml |
1,121 |
984 |
$10K |
| B4088 |
Gastro/jejuno tube, low-pro |
123 |
108 |
$9K |
| B4034 |
Enter feed supkit syr by day |
67 |
64 |
$6K |
| A4244 |
Alcohol or peroxide per pint |
255 |
230 |
$2K |
| A7002 |
Tubing used w suction pump |
1,380 |
1,215 |
$2K |
| A7000 |
Disposable canister for pump |
437 |
381 |
$1K |
| A4245 |
Alcohol wipes per box |
149 |
130 |
$564.86 |
| A7526 |
Tracheostomy tube collar |
112 |
86 |
$413.00 |
| E0562 |
Humidifier heated used w pap |
12 |
12 |
$96.14 |