| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4927 |
Gloves, non-sterile, per 100 |
781 |
702 |
$85K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
221 |
197 |
$31K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
290 |
251 |
$19K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
135 |
110 |
$14K |
| T4541 |
Incontinence product, disposable underpad, large, each |
68 |
62 |
$4K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
906 |
713 |
$3K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
77 |
76 |
$3K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
27 |
26 |
$132.58 |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
61 |
55 |
$0.00 |