| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,036 |
986 |
$109K |
| A4554 |
Disposable underpads, all sizes |
2,280 |
2,159 |
$96K |
| A4927 |
Gloves, non-sterile, per 100 |
1,554 |
1,468 |
$17K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
143 |
142 |
$14K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
101 |
100 |
$12K |
| A4670 |
Automatic blood pressure monitor |
160 |
129 |
$5K |
| E0570 |
Nebulizer, with compressor |
57 |
57 |
$4K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
59 |
59 |
$802.56 |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
17 |
13 |
$770.71 |
| G0008 |
Administration of influenza virus vaccine |
410 |
402 |
$352.22 |
| K0001 |
Standard wheelchair |
13 |
13 |
$193.27 |
| 90694 |
|
47 |
43 |
$157.05 |
| E0605 |
Vaporizer, room type |
17 |
16 |
$156.35 |
| 90653 |
|
18 |
18 |
$130.85 |
| 90686 |
|
153 |
153 |
$100.86 |
| A7015 |
Aerosol mask, used with dme nebulizer |
58 |
58 |
$56.00 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
18 |
17 |
$48.00 |
| 0064A |
|
12 |
12 |
$40.00 |
| 90756 |
|
50 |
50 |
$0.00 |
| 90662 |
|
15 |
14 |
$0.00 |
| 90674 |
|
38 |
37 |
$0.00 |
| 0134A |
|
18 |
16 |
$0.00 |