| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer with compression |
1,278 |
1,277 |
$64K |
| A4362 |
Solid skin barrier |
872 |
872 |
$47K |
| A4409 |
Ost skn barr convex <=4 sq i |
330 |
330 |
$41K |
| A4385 |
Ost skn barrier sld ext wear |
246 |
246 |
$28K |
| A4335 |
Incontinence supply |
643 |
625 |
$15K |
| K0001 |
Standard wheelchair |
356 |
356 |
$10K |
| A4456 |
Adhesive remover, wipes |
659 |
659 |
$8K |
| A5120 |
Skin barrier, wipe or swab |
686 |
686 |
$8K |
| A4394 |
Ostomy pouch liq deodorant |
269 |
268 |
$7K |
| A4406 |
Pectin based ostomy paste |
83 |
83 |
$2K |
| A4927 |
Non-sterile gloves |
33 |
27 |
$1K |
| A7003 |
Nebulizer administration set |
630 |
629 |
$1K |
| A5063 |
Drain ostomy pouch w/flange |
12 |
12 |
$645.86 |
| A7015 |
Aerosol mask used w nebulize |
270 |
270 |
$409.70 |