| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,644 |
3,118 |
$448K |
| A4927 |
Gloves, non-sterile, per 100 |
8,701 |
7,254 |
$400K |
| A4554 |
Disposable underpads, all sizes |
5,598 |
4,665 |
$280K |
| A4928 |
Surgical mask, per 20 |
1,471 |
1,391 |
$201K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,143 |
979 |
$134K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,047 |
849 |
$118K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
364 |
343 |
$48K |
| A4670 |
Automatic blood pressure monitor |
453 |
422 |
$25K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,692 |
1,924 |
$16K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
49 |
39 |
$4K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
49 |
39 |
$2K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
74 |
73 |
$2K |
| S8490 |
Insulin syringes (100 syringes, any size) |
25 |
24 |
$1K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
15 |
12 |
$1K |
| A4259 |
Lancets, per box of 100 |
2,071 |
1,484 |
$1K |
| A4256 |
Normal, low and high calibrator solution / chips |
1,594 |
1,091 |
$923.56 |
| A4258 |
Spring-powered device for lancet, each |
575 |
318 |
$245.25 |
| E0607 |
Home blood glucose monitor |
23 |
14 |
$138.17 |