| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4927 |
Gloves, non-sterile, per 100 |
2,964 |
2,812 |
$55K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
257 |
231 |
$26K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
129 |
118 |
$12K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
646 |
551 |
$11K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
158 |
123 |
$11K |
| T4541 |
Incontinence product, disposable underpad, large, each |
85 |
75 |
$4K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
25 |
24 |
$191.40 |
| A4259 |
Lancets, per box of 100 |
17 |
12 |
$79.49 |