| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
21,160 |
20,825 |
$147K |
| A4927 |
Gloves, non-sterile, per 100 |
2,843 |
2,669 |
$53K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
117 |
109 |
$7K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
60 |
54 |
$3K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
27 |
25 |
$2K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
104 |
100 |
$0.00 |