| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
2,852 |
2,841 |
$36K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
294 |
294 |
$27K |
| A4927 |
Gloves, non-sterile, per 100 |
1,324 |
1,259 |
$18K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
150 |
148 |
$15K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
136 |
135 |
$14K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
104 |
102 |
$12K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
94 |
92 |
$11K |
| T4541 |
Incontinence product, disposable underpad, large, each |
196 |
196 |
$9K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
232 |
228 |
$8K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
69 |
66 |
$6K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
185 |
176 |
$6K |
| 99606 |
|
301 |
80 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
53 |
53 |
$1K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
49 |
49 |
$836.95 |
| A4259 |
Lancets, per box of 100 |
14 |
14 |
$38.37 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
15 |
15 |
$5.83 |