| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
2,051 |
1,993 |
$243K |
| T4541 |
Large disposable underpad |
3,566 |
3,463 |
$178K |
| T4535 |
Disposable liner/shield/pad |
2,914 |
2,835 |
$178K |
| T4526 |
Adult size pull-on med |
1,325 |
1,278 |
$164K |
| T4528 |
Adult size pull-on xl |
1,342 |
1,301 |
$157K |
| A4670 |
Automatic bp monitor, dial |
3,241 |
2,470 |
$139K |
| A4253 |
Blood glucose/reagent strips |
1,312 |
1,263 |
$72K |
| A4927 |
Non-sterile gloves |
3,067 |
2,977 |
$62K |
| A6530 |
Compression stocking bk18-30 |
243 |
226 |
$24K |
| L3908 |
Who cock-up nonmolde pre ots |
213 |
198 |
$14K |
| E0570 |
Nebulizer with compression |
195 |
192 |
$11K |
| A4259 |
Lancets per box |
1,133 |
1,103 |
$10K |
| L0621 |
Sio flex pelvic/sacr pre ots |
70 |
55 |
$2K |
| T4522 |
Adult size brief/diaper med |
16 |
15 |
$1K |
| E0607 |
Blood glucose monitor home |
14 |
14 |
$701.48 |
| A7003 |
Nebulizer administration set |
251 |
248 |
$701.33 |
| Q0513 |
Disp fee inhal drugs/30 days |
24 |
24 |
$361.09 |