| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4100 |
Food thickener, administered orally, per ounce |
680 |
563 |
$34K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
298 |
291 |
$11K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,136 |
1,125 |
$5K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
54 |
50 |
$4K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
1,737 |
1,682 |
$3K |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
672 |
609 |
$1K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
12 |
12 |
$930.24 |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
12 |
12 |
$635.64 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
12 |
12 |
$70.87 |
| A4259 |
Lancets, per box of 100 |
165 |
165 |
$69.30 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
26 |
25 |
$53.61 |