| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
3,644 |
3,118 |
$448K |
| A4927 |
Non-sterile gloves |
8,701 |
7,254 |
$400K |
| A4554 |
Disposable underpads |
5,598 |
4,665 |
$280K |
| A4928 |
Surgical mask |
1,471 |
1,391 |
$201K |
| T4526 |
Adult size pull-on med |
1,143 |
979 |
$134K |
| T4528 |
Adult size pull-on xl |
1,047 |
849 |
$118K |
| E0445 |
Oximeter non-invasive |
364 |
343 |
$48K |
| A4670 |
Automatic bp monitor, dial |
453 |
422 |
$25K |
| A4253 |
Blood glucose/reagent strips |
2,692 |
1,924 |
$16K |
| T4522 |
Adult size brief/diaper med |
49 |
39 |
$4K |
| A9276 |
Disposable sensor, cgm sys |
49 |
39 |
$2K |
| B4152 |
Ef calorie dense>/=1.5kcal |
74 |
73 |
$2K |
| S8490 |
100 insulin syringes |
25 |
24 |
$1K |
| T4523 |
Adult size brief/diaper lg |
15 |
12 |
$1K |
| A4259 |
Lancets per box |
2,071 |
1,484 |
$1K |
| A4256 |
Calibrator solution/chips |
1,594 |
1,091 |
$923.56 |
| A4258 |
Lancet device each |
575 |
318 |
$245.25 |
| E0607 |
Blood glucose monitor home |
23 |
14 |
$138.17 |