| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
1,035 |
801 |
$57K |
| A4554 |
Disposable underpads, all sizes |
2,180 |
1,819 |
$42K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
448 |
394 |
$29K |
| E0570 |
Nebulizer, with compressor |
467 |
373 |
$27K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
943 |
786 |
$22K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
704 |
637 |
$18K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
249 |
222 |
$12K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
174 |
146 |
$11K |
| A4927 |
Gloves, non-sterile, per 100 |
749 |
565 |
$10K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
101 |
88 |
$6K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
106 |
92 |
$5K |
| E0601 |
Continuous positive airway pressure (cpap) device |
44 |
37 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
526 |
424 |
$1K |