| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,257 |
2,126 |
$86K |
| A4670 |
Automatic blood pressure monitor |
1,030 |
1,030 |
$64K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
523 |
478 |
$51K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
469 |
442 |
$43K |
| T4541 |
Incontinence product, disposable underpad, large, each |
737 |
691 |
$31K |
| E0570 |
Nebulizer, with compressor |
465 |
463 |
$27K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
414 |
384 |
$24K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
230 |
225 |
$22K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
501 |
467 |
$21K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
182 |
182 |
$10K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
213 |
211 |
$8K |
| A4259 |
Lancets, per box of 100 |
900 |
866 |
$6K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
88 |
85 |
$6K |
| A4927 |
Gloves, non-sterile, per 100 |
487 |
447 |
$5K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
43 |
42 |
$5K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
84 |
81 |
$5K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
38 |
37 |
$3K |
| E0156 |
Seat attachment, walker |
147 |
147 |
$3K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
138 |
136 |
$2K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
106 |
106 |
$947.63 |
| E0245 |
Tub stool or bench |
12 |
12 |
$900.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
12 |
12 |
$30.29 |