| Code | Description | Claims | Beneficiaries | Total Paid |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
560 |
555 |
$61K |
| A4554 |
Disposable underpads, all sizes |
1,035 |
1,026 |
$55K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
641 |
633 |
$50K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
168 |
166 |
$21K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
639 |
617 |
$10K |
| E0570 |
Nebulizer, with compressor |
74 |
74 |
$6K |
| A4670 |
Automatic blood pressure monitor |
73 |
73 |
$4K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
221 |
221 |
$845.72 |
| A4927 |
Gloves, non-sterile, per 100 |
197 |
195 |
$767.82 |
| A7015 |
Aerosol mask, used with dme nebulizer |
634 |
615 |
$657.56 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
12 |
12 |
$555.64 |