| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
41,489 |
39,267 |
$1.60M |
| A5512 |
Multi den insert direct form |
7,710 |
4,323 |
$383K |
| A5500 |
Diab shoe for density insert |
7,737 |
4,344 |
$335K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
1,221 |
1,219 |
$274K |
| A6530 |
Compression stocking bk18-30 |
4,218 |
3,746 |
$233K |
| A4670 |
Automatic bp monitor, dial |
4,098 |
4,083 |
$204K |
| A4259 |
Lancets per box |
40,983 |
38,780 |
$200K |
| A6533 |
Gc stocking thighlngth 18-30 |
2,346 |
2,116 |
$180K |
| L3908 |
Who cock-up nonmolde pre ots |
2,693 |
2,509 |
$126K |
| A4245 |
Alcohol wipes per box |
39,813 |
37,620 |
$123K |
| L1810 |
Ko elastic with joints |
1,556 |
1,470 |
$102K |
| A6536 |
Gc stocking full lngth 18-30 |
839 |
807 |
$101K |
| E0570 |
Nebulizer with compression |
5,082 |
5,052 |
$100K |
| E1390 |
Oxygen concentrator |
3,449 |
3,419 |
$88K |
| E0601 |
Cont airway pressure device |
1,564 |
1,546 |
$68K |
| K0003 |
Lightweight wheelchair |
2,524 |
2,442 |
$60K |
| A4928 |
Surgical mask |
2,256 |
2,252 |
$58K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,063 |
1,063 |
$35K |
| A7005 |
Nondisposable nebulizer set |
2,112 |
2,092 |
$25K |
| E0143 |
Walker folding wheeled w/o s |
905 |
893 |
$24K |
| B4150 |
Ef complet w/intact nutrient |
444 |
345 |
$20K |
| E0562 |
Humidifier heated used w pap |
1,438 |
1,432 |
$16K |
| B4152 |
Ef calorie dense>/=1.5kcal |
376 |
330 |
$14K |
| A7030 |
Cpap full face mask |
200 |
197 |
$14K |
| B4035 |
Enteral feed supp pump per d |
407 |
342 |
$13K |
| A4256 |
Calibrator solution/chips |
2,623 |
2,568 |
$12K |
| K0738 |
Portable gas oxygen system |
1,280 |
1,277 |
$10K |
| E0431 |
Portable gaseous 02 |
1,051 |
1,025 |
$7K |
| A7037 |
Pos airway pressure tubing |
343 |
339 |
$6K |
| A7035 |
Pos airway press headgear |
238 |
235 |
$4K |
| E0971 |
Wheelchair anti-tipping devi |
1,837 |
1,284 |
$4K |
| E0156 |
Walker seat attachment |
589 |
588 |
$4K |
| E0951 |
Loop heel |
2,807 |
1,928 |
$4K |
| A7031 |
Replacement facemask interfa |
95 |
92 |
$3K |
| A7038 |
Pos airway pressure filter |
485 |
471 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
229 |
218 |
$2K |
| E0607 |
Blood glucose monitor home |
236 |
232 |
$2K |
| L4350 |
Ankle control ortho pre ots |
25 |
25 |
$2K |
| B4034 |
Enter feed supkit syr by day |
149 |
135 |
$1K |
| E1392 |
Portable oxygen concentrator |
232 |
232 |
$1K |
| E0973 |
W/ch access det adj armrest |
391 |
199 |
$934.45 |
| A7015 |
Aerosol mask used w nebulize |
947 |
938 |
$800.35 |
| L0120 |
Cerv flex n/adj foam pre ots |
50 |
50 |
$695.14 |
| E1038 |
Transport chair pt wt<=300lb |
62 |
62 |
$695.01 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
53 |
53 |
$327.68 |
| A7046 |
Repl water chamber, pap dev |
53 |
53 |
$272.50 |
| A7003 |
Nebulizer administration set |
558 |
526 |
$221.87 |
| A4258 |
Lancet device each |
118 |
118 |
$50.08 |
| A9286 |
Any hygienic item, device |
15 |
15 |
$16.50 |