| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
621 |
602 |
$102K |
| A4554 |
Disposable underpads, all sizes |
666 |
649 |
$29K |
| A4927 |
Gloves, non-sterile, per 100 |
665 |
648 |
$11K |
| E0570 |
Nebulizer, with compressor |
107 |
106 |
$6K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
16 |
16 |
$3K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
107 |
106 |
$1K |
| A4670 |
Automatic blood pressure monitor |
20 |
13 |
$829.78 |
| A6531 |
Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each |
26 |
12 |
$410.70 |
| A7015 |
Aerosol mask, used with dme nebulizer |
107 |
106 |
$69.71 |