| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0553 |
Ther cgm supply allowance |
2,786 |
2,604 |
$407K |
| E0604 |
Hosp grade elec breast pump |
1,301 |
1,256 |
$78K |
| A4239 |
Non-adju cgm supply allow |
824 |
785 |
$65K |
| T4535 |
Disposable liner/shield/pad |
1,719 |
1,671 |
$61K |
| T4537 |
Reusable underpad bed size |
1,561 |
1,520 |
$59K |
| K0003 |
Lightweight wheelchair |
1,228 |
1,218 |
$53K |
| A4927 |
Non-sterile gloves |
3,477 |
3,385 |
$49K |
| T4527 |
Adult size pull-on lg |
554 |
544 |
$47K |
| E0570 |
Nebulizer with compression |
1,437 |
1,397 |
$33K |
| T4541 |
Large disposable underpad |
645 |
627 |
$29K |
| K0001 |
Standard wheelchair |
1,352 |
1,333 |
$25K |
| E0143 |
Walker folding wheeled w/o s |
549 |
533 |
$20K |
| E0260 |
Hosp bed semi-electr w/ matt |
545 |
540 |
$11K |
| K0554 |
Ther cgm receiver/monitor |
39 |
37 |
$8K |
| T1999 |
Noc retail items andsupplies |
557 |
547 |
$7K |
| T4526 |
Adult size pull-on med |
67 |
65 |
$5K |
| T4528 |
Adult size pull-on xl |
46 |
40 |
$4K |
| E0630 |
Patient lift hydraulic |
150 |
147 |
$3K |
| E0294 |
Hosp bed semi-elect w/ mattr |
68 |
68 |
$2K |
| E0149 |
Heavy duty wheeled walker |
171 |
164 |
$1K |
| E0156 |
Walker seat attachment |
104 |
100 |
$848.38 |
| A4253 |
Blood glucose/reagent strips |
15 |
14 |
$307.38 |
| A7003 |
Nebulizer administration set |
44 |
40 |
$64.15 |
| A4259 |
Lancets per box |
13 |
12 |
$43.37 |