| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
15,103 |
14,735 |
$548K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,149 |
5,040 |
$459K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,401 |
5,253 |
$458K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,822 |
2,747 |
$337K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
3,635 |
3,448 |
$293K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 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 |
855 |
832 |
$278K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,874 |
2,802 |
$267K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,727 |
2,645 |
$260K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,541 |
1,493 |
$215K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
2,258 |
2,154 |
$192K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
6,192 |
6,012 |
$191K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
2,031 |
1,954 |
$168K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
787 |
736 |
$104K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
379 |
367 |
$33K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,036 |
997 |
$18K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
93 |
85 |
$14K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,179 |
1,118 |
$9K |
| A4456 |
Adhesive remover, wipes, any type, each |
896 |
851 |
$7K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
133 |
124 |
$4K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
177 |
173 |
$2K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
12 |
12 |
$781.12 |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
19 |
12 |
$659.50 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
13 |
12 |
$235.93 |
| A4371 |
Ostomy skin barrier, powder, per oz |
83 |
75 |
$205.90 |