| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4155 |
Ef incomplete/modular |
5,574 |
5,124 |
$3.67M |
| T4526 |
Adult size pull-on med |
10,072 |
8,595 |
$2.17M |
| A6531 |
Compress stking bk30-40 surg |
8,083 |
6,380 |
$1.97M |
| B4153 |
Ef hydrolyzed/amino acids |
3,027 |
2,719 |
$1.06M |
| B4154 |
Ef spec metabolic noninherit |
1,786 |
1,625 |
$609K |
| A4554 |
Disposable underpads |
10,782 |
9,193 |
$603K |
| A4927 |
Non-sterile gloves |
10,869 |
9,267 |
$294K |
| A5120 |
Skin barrier, wipe or swab |
19,247 |
9,349 |
$254K |
| T4522 |
Adult size brief/diaper med |
1,247 |
1,013 |
$152K |
| A6250 |
Skin seal protect moisturizr |
10,845 |
9,254 |
$95K |
| A6530 |
Compression stocking bk18-30 |
462 |
359 |
$53K |
| T4527 |
Adult size pull-on lg |
168 |
163 |
$41K |
| A4253 |
Blood glucose/reagent strips |
1,379 |
1,185 |
$17K |
| A4259 |
Lancets per box |
1,261 |
1,185 |
$2K |
| A4670 |
Automatic bp monitor, dial |
32 |
25 |
$2K |
| E0445 |
Oximeter non-invasive |
49 |
33 |
$572.28 |
| A4520 |
Incontinence garment anytype |
43 |
43 |
$0.00 |