| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,261 |
1,106 |
$77K |
| T4541 |
Incontinence product, disposable underpad, large, each |
479 |
382 |
$23K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
76 |
74 |
$11K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
618 |
475 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
263 |
217 |
$4K |
| A4259 |
Lancets, per box of 100 |
298 |
231 |
$199.73 |