| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
481 |
348 |
$14K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
223 |
145 |
$13K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
120 |
103 |
$4K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
18 |
14 |
$535.07 |
| A4259 |
Lancets, per box of 100 |
50 |
38 |
$356.50 |
| E0570 |
Nebulizer, with compressor |
25 |
25 |
$320.05 |