| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4927 |
Gloves, non-sterile, per 100 |
831 |
822 |
$18K |
| T4541 |
Incontinence product, disposable underpad, large, each |
424 |
420 |
$17K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,760 |
1,622 |
$9K |
| A4553 |
Non-disposable underpads, all sizes |
226 |
224 |
$3K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
140 |
138 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12 |
12 |
$1K |
| A4259 |
Lancets, per box of 100 |
645 |
608 |
$582.17 |
| A4247 |
Betadine or iodine swabs/wipes, per box |
14 |
14 |
$210.00 |
| T4542 |
Incontinence product, disposable underpad, small size, each |
17 |
16 |
$17.00 |
| 0124A |
|
54 |
18 |
$0.00 |