| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
568 |
561 |
$30K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
356 |
355 |
$23K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,342 |
1,341 |
$9K |
| A4554 |
Disposable underpads, all sizes |
202 |
199 |
$4K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
31 |
29 |
$2K |
| A4259 |
Lancets, per box of 100 |
37 |
37 |
$127.89 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
13 |
13 |
$43.33 |