| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,281 |
1,058 |
$193K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,378 |
1,148 |
$186K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
4,756 |
4,454 |
$132K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
491 |
372 |
$53K |
| A4554 |
Disposable underpads, all sizes |
1,169 |
985 |
$45K |
| S8490 |
Insulin syringes (100 syringes, any size) |
2,344 |
2,152 |
$44K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
337 |
266 |
$40K |
| E0570 |
Nebulizer, with compressor |
714 |
641 |
$33K |
| A4259 |
Lancets, per box of 100 |
4,390 |
4,100 |
$19K |
| A4245 |
Alcohol wipes, per box |
4,259 |
3,917 |
$15K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
24 |
24 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,025 |
881 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
16 |
12 |
$2K |
| E0607 |
Home blood glucose monitor |
30 |
25 |
$1K |
| K0001 |
Standard wheelchair |
67 |
67 |
$779.00 |
| A7015 |
Aerosol mask, used with dme nebulizer |
506 |
421 |
$653.90 |
| A4258 |
Spring-powered device for lancet, each |
42 |
37 |
$283.95 |