| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4100 |
Food thickener, administered orally, per ounce |
330 |
320 |
$23K |
| A4215 |
Needle, sterile, any size, each |
702 |
625 |
$15K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
135 |
132 |
$15K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
86 |
81 |
$10K |
| A4259 |
Lancets, per box of 100 |
413 |
398 |
$2K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
24 |
24 |
$2K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
671 |
467 |
$699.82 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
361 |
287 |
$680.00 |
| A4245 |
Alcohol wipes, per box |
373 |
360 |
$577.24 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
1,025 |
992 |
$68.27 |