| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
176 |
168 |
$11K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
421 |
230 |
$10K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
154 |
151 |
$9K |
| J7518 |
Mycophenolic acid, oral, 180 mg |
134 |
124 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
239 |
230 |
$4K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
17 |
15 |
$4K |
| A4554 |
Disposable underpads, all sizes |
65 |
65 |
$3K |
| A4553 |
Non-disposable underpads, all sizes |
179 |
171 |
$3K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12 |
12 |
$1K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
229 |
214 |
$275.76 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
15 |
15 |
$29.11 |