| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5199 |
Personal care item nos each |
918 |
814 |
$142K |
| E1399 |
Durable medical equipment mi |
1,386 |
435 |
$84K |
| A9900 |
Supply/accessory/service |
680 |
347 |
$55K |
| B4153 |
Ef hydrolyzed/amino acids |
38 |
36 |
$27K |
| A4927 |
Non-sterile gloves |
598 |
537 |
$21K |
| A4554 |
Disposable underpads |
494 |
405 |
$16K |
| A4216 |
Sterile water/saline, 10 ml |
525 |
453 |
$12K |
| A4409 |
Ost skn barr convex <=4 sq i |
100 |
97 |
$9K |
| A4406 |
Pectin based ostomy paste |
91 |
88 |
$6K |
| A4385 |
Ost skn barrier sld ext wear |
148 |
145 |
$6K |
| A6211 |
Foam drg > 48 sq in w/o brdr |
12 |
12 |
$6K |
| A4371 |
Skin barrier powder per oz |
116 |
110 |
$6K |
| A6212 |
Foam drg <=16 sq in w/border |
31 |
28 |
$4K |
| A6402 |
Sterile gauze <= 16 sq in |
335 |
308 |
$4K |
| B4088 |
Gastro/jejuno tube, low-pro |
55 |
51 |
$3K |
| A5120 |
Skin barrier, wipe or swab |
334 |
310 |
$3K |
| A4452 |
Waterproof tape |
57 |
52 |
$2K |
| A4450 |
Non-waterproof tape |
79 |
75 |
$2K |
| A4362 |
Solid skin barrier |
26 |
25 |
$2K |
| A4456 |
Adhesive remover, wipes |
108 |
105 |
$1K |
| A4253 |
Blood glucose/reagent strips |
408 |
318 |
$1K |
| A6446 |
Conform band s w>=3" <5"/yd |
69 |
65 |
$699.22 |
| A6216 |
Non-sterile gauze<=16 sq in |
354 |
243 |
$405.52 |
| 0013A |
|
18 |
14 |
$0.00 |
| G0008 |
Admin influenza virus vac |
16 |
12 |
$0.00 |
| 90686 |
|
16 |
12 |
$0.00 |