| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,651 |
1,541 |
$21K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
220 |
220 |
$16K |
| T4541 |
Incontinence product, disposable underpad, large, each |
218 |
217 |
$11K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
247 |
246 |
$10K |
| E0570 |
Nebulizer, with compressor |
398 |
382 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
101 |
92 |
$2K |
| A4259 |
Lancets, per box of 100 |
26 |
26 |
$60.13 |