| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment anytype |
2,817 |
2,735 |
$1.37M |
| A9276 |
Disposable sensor, cgm sys |
1,495 |
1,438 |
$633K |
| B4150 |
Ef complet w/intact nutrient |
2,018 |
1,957 |
$393K |
| E1390 |
Oxygen concentrator |
3,253 |
2,793 |
$216K |
| E0580 |
Nebulizer for use w/ regulat |
1,513 |
1,283 |
$158K |
| A6403 |
Sterile gauze>16 <= 48 sq in |
1,400 |
1,149 |
$148K |
| A6530 |
Compression stocking bk18-30 |
457 |
449 |
$106K |
| T5999 |
Supply, nos |
1,878 |
1,825 |
$95K |
| A9277 |
External transmitter, cgm |
145 |
135 |
$88K |
| L3923 |
Hfo without joints pre cst |
985 |
886 |
$86K |
| L1810 |
Ko elastic with joints |
794 |
726 |
$79K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
108 |
106 |
$78K |
| A6444 |
Conform band n/s w>=5"/yd |
742 |
614 |
$66K |
| T4541 |
Large disposable underpad |
1,224 |
1,183 |
$62K |
| A4670 |
Automatic bp monitor, dial |
1,420 |
1,343 |
$59K |
| E0431 |
Portable gaseous 02 |
2,541 |
2,407 |
$59K |
| A6260 |
Wound cleanser any type/size |
379 |
369 |
$48K |
| A4230 |
Infus insulin pump non needl |
140 |
139 |
$40K |
| A4927 |
Non-sterile gloves |
2,049 |
2,000 |
$38K |
| A4217 |
Sterile water/saline, 500 ml |
370 |
328 |
$24K |
| A4554 |
Disposable underpads |
482 |
480 |
$20K |
| S8186 |
Swivel adaptor |
2,645 |
2,527 |
$19K |
| L1270 |
Abdominal pad |
252 |
206 |
$18K |
| E0144 |
Enclosed walker w rear seat |
73 |
61 |
$14K |
| A4615 |
Cannula nasal |
3,305 |
2,713 |
$14K |
| A4627 |
Spacer bag/reservoir |
498 |
458 |
$14K |
| A4430 |
Ost urine pch w b/bltin conv |
41 |
40 |
$14K |
| A4450 |
Non-waterproof tape |
808 |
684 |
$12K |
| S8101 |
Spacer with mask |
342 |
324 |
$11K |
| E0100 |
Cane adjust/fixed with tip |
527 |
464 |
$10K |
| T4535 |
Disposable liner/shield/pad |
125 |
125 |
$9K |
| A7030 |
Cpap full face mask |
117 |
93 |
$9K |
| A4616 |
Tubing (oxygen) per foot |
3,161 |
2,717 |
$8K |
| A4232 |
Syringe w/needle insulin 3cc |
138 |
138 |
$8K |
| E0601 |
Cont airway pressure device |
13 |
13 |
$6K |
| A6533 |
Gc stocking thighlngth 18-30 |
13 |
13 |
$5K |
| A7009 |
Nebulizer reservoir bottle |
131 |
131 |
$4K |
| L1812 |
Ko elastic w/joints pre ots |
51 |
51 |
$4K |
| A7031 |
Replacement facemask interfa |
105 |
64 |
$4K |
| A6449 |
Lt compres band >=3" <5"/yd |
36 |
36 |
$3K |
| E0562 |
Humidifier heated used w pap |
13 |
13 |
$2K |
| E1399 |
Durable medical equipment mi |
263 |
245 |
$2K |
| A7035 |
Pos airway press headgear |
80 |
80 |
$1K |
| A7037 |
Pos airway pressure tubing |
90 |
79 |
$1K |
| A4663 |
Dialysis blood pressure cuff |
82 |
82 |
$897.78 |
| A4456 |
Adhesive remover, wipes |
40 |
37 |
$857.32 |
| A7036 |
Pos airway press chinstrap |
85 |
74 |
$796.93 |
| A7038 |
Pos airway pressure filter |
170 |
146 |
$641.17 |
| E0443 |
Portable 02 contents, gas |
178 |
164 |
$598.25 |
| A7039 |
Filter, non disposable w pap |
92 |
78 |
$546.58 |