| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4152 |
Ef calorie dense>/=1.5kcal |
1,045 |
667 |
$68K |
| A4927 |
Non-sterile gloves |
1,926 |
1,846 |
$32K |
| B4034 |
Enter feed supkit syr by day |
1,273 |
741 |
$29K |
| E0601 |
Cont airway pressure device |
852 |
633 |
$24K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,058 |
1,590 |
$11K |
| K0001 |
Standard wheelchair |
4,030 |
1,579 |
$11K |
| E1390 |
Oxygen concentrator |
710 |
261 |
$5K |
| E0570 |
Nebulizer with compression |
4,912 |
1,865 |
$5K |
| A4253 |
Blood glucose/reagent strips |
1,110 |
555 |
$5K |
| B4150 |
Ef complet w/intact nutrient |
46 |
38 |
$4K |
| E0630 |
Patient lift hydraulic |
636 |
222 |
$2K |
| E0562 |
Humidifier heated used w pap |
747 |
579 |
$2K |
| E0265 |
Hosp bed total electr w/ mat |
199 |
69 |
$726.01 |
| A4259 |
Lancets per box |
962 |
497 |
$489.96 |
| Q0513 |
Disp fee inhal drugs/30 days |
861 |
246 |
$328.67 |
| A7003 |
Nebulizer administration set |
1,324 |
448 |
$168.84 |
| E0143 |
Walker folding wheeled w/o s |
190 |
46 |
$133.72 |
| K0195 |
Elevating whlchair leg rests |
204 |
53 |
$124.16 |
| E1038 |
Transport chair pt wt<=300lb |
1,508 |
428 |
$97.37 |
| A7015 |
Aerosol mask used w nebulize |
1,213 |
372 |
$26.78 |
| E0156 |
Walker seat attachment |
41 |
12 |
$5.14 |
| A4256 |
Calibrator solution/chips |
84 |
76 |
$4.76 |
| 0124A |
|
25 |
25 |
$0.00 |
| 0051A |
|
38 |
29 |
$0.00 |
| A4258 |
Lancet device each |
14 |
14 |
$0.00 |