| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
472 |
392 |
$34K |
| T4541 |
Incontinence product, disposable underpad, large, each |
158 |
155 |
$6K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,317 |
1,221 |
$4K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
438 |
424 |
$4K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
24 |
24 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
14 |
12 |
$156.42 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
67 |
62 |
$119.97 |
| A4259 |
Lancets, per box of 100 |
92 |
87 |
$29.31 |