| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
985 |
937 |
$89K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
978 |
858 |
$77K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
769 |
666 |
$46K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
439 |
389 |
$39K |
| A4554 |
Disposable underpads, all sizes |
1,063 |
963 |
$37K |
| A4927 |
Gloves, non-sterile, per 100 |
1,473 |
1,322 |
$20K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
345 |
289 |
$16K |
| A4259 |
Lancets, per box of 100 |
30 |
28 |
$279.00 |