| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
54,881 |
54,443 |
$2.77M |
| 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 |
24,937 |
23,148 |
$2.08M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
56,907 |
53,272 |
$1.51M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
13,223 |
13,152 |
$1.49M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
24,356 |
22,971 |
$1.24M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
14,931 |
14,777 |
$1.04M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
8,323 |
8,271 |
$897K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
16,113 |
16,015 |
$873K |
| 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 |
18,315 |
16,690 |
$863K |
| 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 |
14,440 |
12,892 |
$635K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
6,215 |
6,144 |
$426K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
5,119 |
5,050 |
$413K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,802 |
1,603 |
$257K |
| E0776 |
Iv pole |
56,593 |
53,665 |
$251K |
| B9002 |
Enteral nutrition infusion pump, any type |
18,610 |
17,666 |
$219K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
3,821 |
3,786 |
$197K |
| A4335 |
Incontinence supply; miscellaneous |
9,258 |
9,202 |
$103K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
8,396 |
8,336 |
$98K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
4,131 |
3,866 |
$89K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
1,898 |
1,883 |
$19K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
79 |
70 |
$2K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
13 |
13 |
$336.72 |