| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,701 |
1,578 |
$166K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,423 |
1,337 |
$158K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
971 |
906 |
$120K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
988 |
954 |
$89K |
| 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 |
1,166 |
934 |
$86K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
3,119 |
3,037 |
$79K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,583 |
1,517 |
$66K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
552 |
538 |
$52K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,499 |
1,462 |
$51K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
263 |
251 |
$50K |
| A4927 |
Gloves, non-sterile, per 100 |
2,264 |
2,026 |
$49K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
433 |
404 |
$41K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
441 |
427 |
$39K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
410 |
398 |
$36K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
266 |
247 |
$26K |
| 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 |
59 |
53 |
$8K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
16 |
14 |
$2K |