| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,593 |
1,565 |
$133K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
709 |
701 |
$100K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,325 |
1,309 |
$49K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
383 |
379 |
$42K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
922 |
914 |
$39K |
| S9999 |
Sales tax |
3,722 |
3,526 |
$36K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
155 |
154 |
$21K |
| A4927 |
Gloves, non-sterile, per 100 |
555 |
533 |
$21K |
| E0570 |
Nebulizer, with compressor |
921 |
899 |
$14K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
13 |
13 |
$52.16 |
| G0008 |
Administration of influenza virus vaccine |
126 |
126 |
$0.00 |
| 90480 |
|
61 |
61 |
$0.00 |
| 0011A |
|
51 |
51 |
$0.00 |
| 0031A |
|
83 |
83 |
$0.00 |
| 0134A |
|
12 |
12 |
$0.00 |
| 0064A |
|
87 |
87 |
$0.00 |
| 0012A |
|
55 |
55 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| 90662 |
|
15 |
15 |
$0.00 |
| 91322 |
|
22 |
22 |
$0.00 |
| 0034A |
|
16 |
16 |
$0.00 |