| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
3,955 |
3,767 |
$54K |
| T4541 |
Large disposable underpad |
519 |
461 |
$15K |
| B4150 |
Ef complet w/intact nutrient |
150 |
121 |
$12K |
| B4152 |
Ef calorie dense>/=1.5kcal |
80 |
77 |
$7K |
| T4535 |
Disposable liner/shield/pad |
97 |
89 |
$4K |
| A4245 |
Alcohol wipes per box |
1,198 |
1,115 |
$4K |
| A4259 |
Lancets per box |
2,478 |
2,386 |
$3K |
| E0607 |
Blood glucose monitor home |
25 |
25 |
$2K |
| E0570 |
Nebulizer with compression |
253 |
234 |
$2K |
| T4522 |
Adult size brief/diaper med |
12 |
12 |
$1K |
| A4927 |
Non-sterile gloves |
52 |
51 |
$339.15 |
| T4537 |
Reusable underpad bed size |
12 |
12 |
$337.68 |
| A4258 |
Lancet device each |
28 |
27 |
$44.60 |