| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
5,658 |
5,431 |
$190K |
| T4523 |
Adult size brief/diaper lg |
1,082 |
988 |
$94K |
| A4670 |
Automatic bp monitor, dial |
1,396 |
1,331 |
$72K |
| T4524 |
Adult size brief/diaper xl |
387 |
351 |
$33K |
| T4522 |
Adult size brief/diaper med |
360 |
334 |
$21K |
| A4259 |
Lancets per box |
2,271 |
2,230 |
$15K |
| T4541 |
Large disposable underpad |
162 |
155 |
$7K |
| E0570 |
Nebulizer with compression |
126 |
120 |
$6K |
| Q0513 |
Disp fee inhal drugs/30 days |
562 |
541 |
$6K |
| T4535 |
Disposable liner/shield/pad |
61 |
56 |
$2K |
| E0605 |
Vaporizer room type |
65 |
53 |
$1K |
| J7613 |
Albuterol non-comp unit |
408 |
296 |
$685.30 |