| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
7,764 |
7,375 |
$470K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,376 |
2,271 |
$381K |
| A4927 |
Gloves, non-sterile, per 100 |
7,532 |
7,173 |
$233K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,394 |
1,337 |
$219K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,277 |
1,236 |
$184K |
| A4670 |
Automatic blood pressure monitor |
1,332 |
1,145 |
$74K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
247 |
229 |
$57K |
| 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 |
483 |
433 |
$43K |
| E0570 |
Nebulizer, with compressor |
826 |
595 |
$30K |
| A4335 |
Incontinence supply; miscellaneous |
3,018 |
2,866 |
$24K |
| K0001 |
Standard wheelchair |
165 |
126 |
$6K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
39 |
37 |
$5K |
| 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 |
40 |
36 |
$5K |
| E1639 |
Scale, each |
30 |
30 |
$2K |