| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
232 |
216 |
$23K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
149 |
142 |
$15K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
150 |
140 |
$14K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
469 |
432 |
$12K |
| 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 |
104 |
78 |
$9K |
| T4541 |
Incontinence product, disposable underpad, large, each |
78 |
74 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
131 |
112 |
$3K |