| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q0511 |
Sup fee antiem,antica,immuno |
176 |
168 |
$11K |
| Q0512 |
Px sup fee anti-can sub pres |
421 |
230 |
$10K |
| T4535 |
Disposable liner/shield/pad |
154 |
151 |
$9K |
| J7518 |
Mycophenolic acid |
134 |
124 |
$5K |
| A4927 |
Non-sterile gloves |
239 |
230 |
$4K |
| A6530 |
Compression stocking bk18-30 |
17 |
15 |
$4K |
| A4554 |
Disposable underpads |
65 |
65 |
$3K |
| A4553 |
Nondisp underpads, all sizes |
179 |
171 |
$3K |
| T4527 |
Adult size pull-on lg |
12 |
12 |
$1K |
| J7512 |
Prednisone ir or dr oral 1mg |
229 |
214 |
$275.76 |
| A4253 |
Blood glucose/reagent strips |
15 |
15 |
$29.11 |