| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult size brief/diaper lg |
560 |
555 |
$61K |
| A4554 |
Disposable underpads |
1,035 |
1,026 |
$55K |
| T4522 |
Adult size brief/diaper med |
641 |
633 |
$50K |
| T4524 |
Adult size brief/diaper xl |
168 |
166 |
$21K |
| A7005 |
Nondisposable nebulizer set |
639 |
617 |
$10K |
| E0570 |
Nebulizer with compression |
74 |
74 |
$6K |
| A4670 |
Automatic bp monitor, dial |
73 |
73 |
$4K |
| A4253 |
Blood glucose/reagent strips |
221 |
221 |
$845.72 |
| A4927 |
Non-sterile gloves |
197 |
195 |
$767.82 |
| A7015 |
Aerosol mask used w nebulize |
634 |
615 |
$657.56 |
| T4535 |
Disposable liner/shield/pad |
12 |
12 |
$555.64 |