| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
8,811 |
7,862 |
$441K |
| A4554 |
Disposable underpads |
4,464 |
4,111 |
$211K |
| T4524 |
Adult size brief/diaper xl |
1,412 |
1,265 |
$179K |
| T4528 |
Adult size pull-on xl |
1,176 |
1,028 |
$136K |
| T4527 |
Adult size pull-on lg |
909 |
818 |
$109K |
| T4523 |
Adult size brief/diaper lg |
688 |
642 |
$96K |
| A4259 |
Lancets per box |
8,760 |
7,853 |
$94K |
| E0607 |
Blood glucose monitor home |
1,298 |
1,165 |
$69K |
| A4927 |
Non-sterile gloves |
2,712 |
2,350 |
$35K |
| T4526 |
Adult size pull-on med |
274 |
233 |
$24K |
| A4247 |
Betadine/iodine swabs/wipes |
2,707 |
2,351 |
$23K |
| A4206 |
1 cc sterile syringe&needle |
1,515 |
1,169 |
$17K |
| A4258 |
Lancet device each |
1,190 |
1,060 |
$9K |
| T4522 |
Adult size brief/diaper med |
60 |
60 |
$6K |
| T4525 |
Adult size pull-on sm |
48 |
48 |
$4K |
| A6250 |
Skin seal protect moisturizr |
247 |
245 |
$3K |
| L1833 |
Ko adj jnt pos r sup pre ots |
12 |
12 |
$3K |