| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
4,728 |
4,529 |
$88K |
| T4527 |
Adult size pull-on lg |
994 |
816 |
$63K |
| A4215 |
Sterile needle |
2,652 |
2,580 |
$52K |
| T4535 |
Disposable liner/shield/pad |
1,008 |
843 |
$38K |
| T4541 |
Large disposable underpad |
1,660 |
1,398 |
$37K |
| T4523 |
Adult size brief/diaper lg |
400 |
372 |
$35K |
| T4526 |
Adult size pull-on med |
730 |
588 |
$29K |
| A4927 |
Non-sterile gloves |
2,503 |
2,000 |
$27K |
| T4522 |
Adult size brief/diaper med |
269 |
250 |
$23K |
| S8490 |
100 insulin syringes |
1,378 |
1,292 |
$19K |
| T4528 |
Adult size pull-on xl |
265 |
236 |
$16K |
| E0570 |
Nebulizer with compression |
237 |
236 |
$4K |
| E1399 |
Durable medical equipment mi |
1,175 |
1,148 |
$4K |
| T4534 |
Youth size pull-on |
29 |
24 |
$4K |
| A4259 |
Lancets per box |
2,198 |
2,153 |
$3K |
| A4245 |
Alcohol wipes per box |
1,362 |
1,326 |
$3K |
| E0607 |
Blood glucose monitor home |
247 |
245 |
$3K |
| A4670 |
Automatic bp monitor, dial |
42 |
41 |
$2K |
| T4537 |
Reusable underpad bed size |
19 |
17 |
$1K |
| A4627 |
Spacer bag/reservoir |
116 |
116 |
$891.37 |
| A7003 |
Nebulizer administration set |
257 |
251 |
$466.52 |
| A7015 |
Aerosol mask used w nebulize |
13 |
13 |
$21.42 |
| A4335 |
Incontinence supply |
27 |
24 |
$0.00 |
| A4520 |
Incontinence garment anytype |
31 |
14 |
$0.00 |