| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
1,142 |
1,060 |
$31K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
275 |
258 |
$22K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
341 |
297 |
$21K |
| E0570 |
Nebulizer, with compressor |
924 |
551 |
$21K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
611 |
536 |
$17K |
| A4927 |
Gloves, non-sterile, per 100 |
701 |
656 |
$14K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
45 |
38 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
13 |
13 |
$1K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
144 |
118 |
$364.48 |