| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0221 |
Infrared heating pad system |
49 |
34 |
$121K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
463 |
456 |
$71K |
| A4554 |
Disposable underpads, all sizes |
1,006 |
993 |
$56K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
909 |
888 |
$45K |
| A4927 |
Gloves, non-sterile, per 100 |
1,307 |
1,207 |
$28K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
184 |
181 |
$24K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
73 |
70 |
$14K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
62 |
61 |
$12K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,326 |
1,200 |
$12K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
29 |
25 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
84 |
78 |
$2K |
| A4259 |
Lancets, per box of 100 |
81 |
74 |
$300.41 |
| A4245 |
Alcohol wipes, per box |
52 |
52 |
$270.00 |