| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer with compression |
15,468 |
14,523 |
$1.01M |
| A4351 |
Straight tip urine catheter |
1,254 |
1,211 |
$209K |
| B4150 |
Ef complet w/intact nutrient |
1,608 |
1,567 |
$195K |
| B4035 |
Enteral feed supp pump per d |
771 |
695 |
$192K |
| B9998 |
Enteral supp not otherwise c |
722 |
712 |
$103K |
| L3216 |
Orthoped ladies shoes dpth i |
1,387 |
1,092 |
$98K |
| L3020 |
Foot longitud/metatarsal sup |
1,101 |
941 |
$95K |
| A6530 |
Compression stocking bk18-30 |
1,553 |
1,434 |
$91K |
| A6533 |
Gc stocking thighlngth 18-30 |
749 |
715 |
$70K |
| A4554 |
Disposable underpads |
2,223 |
2,128 |
$67K |
| T4526 |
Adult size pull-on med |
788 |
770 |
$59K |
| A4670 |
Automatic bp monitor, dial |
2,287 |
2,196 |
$56K |
| A7006 |
Filtered nebulizer admin set |
13,415 |
12,614 |
$55K |
| E1399 |
Durable medical equipment mi |
79 |
74 |
$54K |
| K0001 |
Standard wheelchair |
1,974 |
1,892 |
$48K |
| T4527 |
Adult size pull-on lg |
528 |
502 |
$45K |
| A7016 |
Nebulizer dome & mouthpiece |
13,385 |
12,588 |
$44K |
| L3221 |
Orthopedic mens shoes dpth i |
505 |
423 |
$41K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,136 |
1,092 |
$41K |
| B4088 |
Gastro/jejuno tube, low-pro |
542 |
493 |
$40K |
| A4213 |
20+ cc syringe only |
969 |
948 |
$39K |
| E0143 |
Walker folding wheeled w/o s |
1,156 |
1,128 |
$34K |
| T4528 |
Adult size pull-on xl |
410 |
359 |
$33K |
| A4927 |
Non-sterile gloves |
1,996 |
1,888 |
$28K |
| E0245 |
Tub stool or bench |
296 |
275 |
$16K |
| A7015 |
Aerosol mask used w nebulize |
13,362 |
12,475 |
$12K |
| K0195 |
Elevating whlchair leg rests |
1,472 |
1,386 |
$12K |
| A6402 |
Sterile gauze <= 16 sq in |
953 |
902 |
$12K |
| A4616 |
Tubing (oxygen) per foot |
13,252 |
12,454 |
$11K |
| E0445 |
Oximeter non-invasive |
236 |
236 |
$11K |
| A4402 |
Lubricant per ounce |
741 |
729 |
$10K |
| L0648 |
Lso sag r an/pos pnl pre ots |
26 |
25 |
$9K |
| L3931 |
Whfo nontorsion joint prefab |
100 |
89 |
$9K |
| E0156 |
Walker seat attachment |
1,280 |
1,248 |
$8K |
| A4217 |
Sterile water/saline, 500 ml |
321 |
316 |
$7K |
| A4450 |
Non-waterproof tape |
436 |
426 |
$4K |
| A6539 |
Gc stocking waistlngth 18-30 |
32 |
32 |
$3K |
| T4523 |
Adult size brief/diaper lg |
26 |
25 |
$2K |
| E0560 |
Humidifier supplemental w/ i |
30 |
30 |
$2K |
| A4344 |
Cath indw foley 2 way silicn |
12 |
12 |
$2K |
| A5061 |
Pouch drainable w barrier at |
12 |
12 |
$1K |
| L8030 |
Breast prosthes w/o adhesive |
13 |
12 |
$1K |
| T4524 |
Adult size brief/diaper xl |
13 |
13 |
$1K |
| E0100 |
Cane adjust/fixed with tip |
111 |
109 |
$1K |
| L8000 |
Mastectomy bra |
25 |
25 |
$603.03 |
| L3040 |
Ft arch suprt premold longit |
18 |
12 |
$192.24 |
| E0105 |
Cane adjust/fixed quad/3 pro |
29 |
24 |
$184.71 |
| A5500 |
Diab shoe for density insert |
20 |
12 |
$160.08 |