| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
15,392 |
15,221 |
$2.20M |
| A6530 |
Compression stocking bk18-30 |
11,852 |
8,226 |
$1.64M |
| A4467 |
Belt strap sleev grmnt cover |
11,519 |
11,025 |
$530K |
| T4527 |
Adult size pull-on lg |
3,208 |
3,190 |
$449K |
| A4554 |
Disposable underpads |
9,876 |
9,830 |
$370K |
| A6533 |
Gc stocking thighlngth 18-30 |
1,384 |
1,119 |
$312K |
| T4535 |
Disposable liner/shield/pad |
5,624 |
5,604 |
$242K |
| T4526 |
Adult size pull-on med |
1,745 |
1,729 |
$199K |
| T4528 |
Adult size pull-on xl |
1,089 |
1,079 |
$167K |
| A4670 |
Automatic bp monitor, dial |
1,334 |
1,312 |
$71K |
| A4335 |
Incontinence supply |
10,384 |
10,334 |
$54K |
| E0570 |
Nebulizer with compression |
377 |
374 |
$42K |
| A4556 |
Electrodes, pair |
205 |
202 |
$31K |
| T4534 |
Youth size pull-on |
171 |
168 |
$20K |
| A7005 |
Nondisposable nebulizer set |
377 |
374 |
$7K |
| A4557 |
Lead wires, pair |
205 |
202 |
$5K |
| A6539 |
Gc stocking waistlngth 18-30 |
12 |
12 |
$1K |
| S8101 |
Spacer with mask |
28 |
28 |
$752.03 |
| A5500 |
Diab shoe for density insert |
16 |
16 |
$0.00 |
| A5512 |
Multi den insert direct form |
15 |
15 |
$0.00 |