| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads |
10,582 |
9,230 |
$557K |
| B4150 |
Ef complet w/intact nutrient |
5,600 |
4,837 |
$546K |
| T4523 |
Adult size brief/diaper lg |
3,967 |
3,471 |
$415K |
| B4154 |
Ef spec metabolic noninherit |
2,474 |
2,035 |
$271K |
| T4524 |
Adult size brief/diaper xl |
2,349 |
2,090 |
$270K |
| T4522 |
Adult size brief/diaper med |
2,393 |
2,100 |
$238K |
| A4253 |
Blood glucose/reagent strips |
1,742 |
1,387 |
$144K |
| A4927 |
Non-sterile gloves |
4,492 |
3,653 |
$130K |
| T4543 |
Adult disp brief/diap abv xl |
300 |
245 |
$53K |
| A4670 |
Automatic bp monitor, dial |
466 |
398 |
$25K |
| B4152 |
Ef calorie dense>/=1.5kcal |
147 |
124 |
$21K |
| A4259 |
Lancets per box |
1,674 |
1,387 |
$19K |
| A4244 |
Alcohol or peroxide per pint |
494 |
426 |
$3K |
| A4258 |
Lancet device each |
120 |
119 |
$2K |
| A4234 |
J-cell batt for glucose mon |
501 |
444 |
$1K |
| E0607 |
Blood glucose monitor home |
21 |
20 |
$1K |
| A4335 |
Incontinence supply |
78 |
75 |
$530.79 |