| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,402 |
1,325 |
$29K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
131 |
113 |
$11K |
| A4927 |
Gloves, non-sterile, per 100 |
631 |
566 |
$9K |
| A4259 |
Lancets, per box of 100 |
1,216 |
1,148 |
$5K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
55 |
49 |
$5K |
| 0012A |
|
50 |
50 |
$1K |
| 0011A |
|
52 |
51 |
$1K |
| 0064A |
|
61 |
60 |
$400.01 |
| 91301 |
|
38 |
33 |
$0.36 |