| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,321 |
3,320 |
$480K |
| A4554 |
Disposable underpads, all sizes |
10,540 |
10,480 |
$395K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,248 |
1,236 |
$249K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,511 |
5,486 |
$244K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,133 |
2,116 |
$240K |
| A4335 |
Incontinence supply; miscellaneous |
11,399 |
11,323 |
$64K |
| E0570 |
Nebulizer, with compressor |
325 |
320 |
$31K |
| A4670 |
Automatic blood pressure monitor |
145 |
145 |
$9K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
272 |
268 |
$5K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
314 |
313 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
273 |
269 |
$348.46 |
| A4259 |
Lancets, per box of 100 |
274 |
273 |
$121.74 |
| 0002A |
|
17 |
17 |
$0.00 |
| 0011A |
|
44 |
44 |
$0.00 |
| 0001A |
|
49 |
49 |
$0.00 |
| 0031A |
|
54 |
54 |
$0.00 |