| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,401 |
2,305 |
$541K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,687 |
1,539 |
$487K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,130 |
2,019 |
$468K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,043 |
1,964 |
$433K |
| A4335 |
Incontinence supply; miscellaneous |
10,281 |
9,388 |
$423K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,755 |
1,680 |
$347K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,963 |
2,853 |
$305K |
| T4541 |
Incontinence product, disposable underpad, large, each |
6,288 |
6,110 |
$298K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,240 |
1,184 |
$276K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
5,831 |
5,642 |
$183K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
717 |
656 |
$167K |
| A4927 |
Gloves, non-sterile, per 100 |
1,989 |
1,855 |
$166K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
278 |
263 |
$71K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
3,151 |
3,060 |
$67K |
| A4554 |
Disposable underpads, all sizes |
329 |
320 |
$32K |
| B4100 |
Food thickener, administered orally, per ounce |
14 |
12 |
$7K |