| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
5,291 |
5,093 |
$1.32M |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,714 |
1,507 |
$443K |
| A4554 |
Disposable underpads, all sizes |
5,905 |
5,710 |
$347K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
448 |
392 |
$170K |
| A4927 |
Gloves, non-sterile, per 100 |
3,805 |
3,633 |
$81K |
| A4259 |
Lancets, per box of 100 |
1,722 |
1,513 |
$39K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
214 |
212 |
$35K |
| E0570 |
Nebulizer, with compressor |
69 |
58 |
$7K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
68 |
57 |
$1K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
12 |
12 |
$590.49 |