| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
1,742 |
1,701 |
$100K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,012 |
987 |
$95K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
172 |
171 |
$19K |
| A4335 |
Incontinence supply; miscellaneous |
744 |
694 |
$17K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
77 |
77 |
$10K |
| 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 |
116 |
116 |
$6K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
280 |
276 |
$4K |