| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
263 |
196 |
$16K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
356 |
281 |
$7K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
14 |
13 |
$1K |
| T4541 |
Incontinence product, disposable underpad, large, each |
19 |
19 |
$507.28 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
25 |
24 |
$237.60 |
| A4259 |
Lancets, per box of 100 |
27 |
25 |
$159.11 |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
69 |
48 |
$0.00 |